Noninvasive biomagnetic detection of intestinal slow wave dysrhythmias in chronic mesenteric ischemia.
Chronic mesenteric ischemia (CMI) is a challenging clinical problem that is difficult to diagnose noninvasively. Diagnosis early in the disease process would enable life-saving early surgical intervention. Previous studies established that superconducting quantum interference device (SQUID) magnetometers detect the slow wave changes in the magnetoenterogram (MENG) noninvasively following induction of mesenteric ischemia in animal models. The purpose of this study was to assess functional physiological changes in the intestinal slow wave MENG of patients with chronic mesenteric ischemia. Pre- and postoperative studies were conducted on CMI patients using MENG and intraoperative recordings using invasive serosal electromyograms (EMG). Our preoperative MENG recordings showed that patients with CMI exhibited a significant decrease in intestinal slow wave frequency from 8.9 ± 0.3 cpm preprandial to 7.4 ± 0.1 cpm postprandial (P < 0.01) that was not observed in postoperative recordings (9.3 ± 0.2 cpm preprandial and 9.4 ± 0.4 cpm postprandial, P = 0.86). Intraoperative recording detected multiple frequencies from the ischemic portion of jejunum before revascularization, whereas normal serosal intestinal slow wave frequencies were observed after revascularization. The preoperative MENG data also showed signals with multiple frequencies suggestive of uncoupling and intestinal ischemia similar to intraoperative serosal EMG. Our results showed that multichannel MENG can identify intestinal slow wave dysrhythmias in CMI patients.
Department of Surgery, Vanderbilt University, Nashville, Tennessee; Department of Physics and Astronomy, Vanderbilt University, Nashville, Tennessee; suseela.somarajan@vanderbilt.edu.
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Somarajan
Department of Surgery, Vanderbilt University, Nashville, Tennessee; Department of Physics and Astronomy, Vanderbilt University, Nashville, Tennessee;
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Muszynski
Department of Surgery, Vanderbilt University, Nashville, Tennessee; Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand;
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Cheng
Department of Surgery, Vanderbilt University, Nashville, Tennessee; Department of Physics and Astronomy, Vanderbilt University, Nashville, Tennessee; Department of Physics, Lipscomb University, Nashville, Tennessee;
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Bradshaw
Division of Vascular Surgery, Vanderbilt University, Nashville, Tennessee; and.
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Naslund
Department of Surgery, University of South Alabama College of Medicine, Mobile, Alabama.
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Richards
D002908:Chronic Disease; D004435:Eating; D004568:Electrodiagnosis / Q000379:methods*; D004576:Electromyography; D005769:Gastrointestinal Motility; D006801:Humans; D007583:Jejunum / Q000503:physiopathology* / Q000601:surgery; D060306:Magnetometry / Q000379:methods*; D065666:Mesenteric Ischemia / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D019518:Postprandial Period; D011237:Predictive Value of Tests; D013997:Time Factors
magnetoenterogram; mesenteric ischemia; slow wave