Author of 1 Presentation
SS 6.8 - Assessment of small bowel motility in chronic intestinal pseudo-obstruction using caloric stimulation and cine-MRI
Abstract
Purpose
Chronic intestinal pseudo-obstruction (CIPO) is a severe digestive disorder, characterized by failure of intestinal motility. MRI has emerged as a non-invasive method for evaluating bowel motility. This study aimed to gain insight into fasted and fed small bowel motility in CIPO patients.
Material and methods
Eight CIPO patients underwent a cine-MRI protocol comprising of fasting state scans and subsequently postprandial scans after orally ingesting a small-volume, high-caloric-density, test meal (Nutridrink, 300 kcal). Small bowel motility was visually scored by an experienced abdominal radiologist as well as quantified by a validated post-processing technique (GIQuant, Motilent, UK) with a new edge-detection technique to account for dilated bowel, resulting in a motility score (arbitrary units (AU)). Motility scores were compared with healthy volunteers that previously underwent a similar cine-MRI protocol.
Results
Visually, motility was increased in four out of eight CIPO patients, six showed distended bowels filled with air and/or intestinal content. Motility quantitation demonstrated a median fasted small bowel motility of 0.21 AU (IQR 0.15-0.30) and directly after intake of the meal 0.23 AU (IQR 0.15-0.27). In healthy volunteers, corresponding fasted and fed motility were 0.18 AU (IQR 0.14-0.24) and 0.25 AU (IQR 0.20-0.29), respectively.
Conclusion
Surprisingly, we found hyperactive small bowel motility in half of the CIPO patients, suggestive of uncoordinated intestinal motility. Quantitation showed a wide variation in motility patterns, with both higher and lower motility than in healthy subjects, and an absence of postprandial activation. Dynamic MRI helps to gain insight into this complex disease and can potentially impact treatment decisions in the future.
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Author of 1 Presentation
SS 6.8 - Assessment of small bowel motility in chronic intestinal pseudo-obstruction using caloric stimulation and cine-MRI (ID 747)
Abstract
Purpose
Chronic intestinal pseudo-obstruction (CIPO) is a severe digestive disorder, characterized by failure of intestinal motility. MRI has emerged as a non-invasive method for evaluating bowel motility. This study aimed to gain insight into fasted and fed small bowel motility in CIPO patients.
Material and methods
Eight CIPO patients underwent a cine-MRI protocol comprising of fasting state scans and subsequently postprandial scans after orally ingesting a small-volume, high-caloric-density, test meal (Nutridrink, 300 kcal). Small bowel motility was visually scored by an experienced abdominal radiologist as well as quantified by a validated post-processing technique (GIQuant, Motilent, UK) with a new edge-detection technique to account for dilated bowel, resulting in a motility score (arbitrary units (AU)). Motility scores were compared with healthy volunteers that previously underwent a similar cine-MRI protocol.
Results
Visually, motility was increased in four out of eight CIPO patients, six showed distended bowels filled with air and/or intestinal content. Motility quantitation demonstrated a median fasted small bowel motility of 0.21 AU (IQR 0.15-0.30) and directly after intake of the meal 0.23 AU (IQR 0.15-0.27). In healthy volunteers, corresponding fasted and fed motility were 0.18 AU (IQR 0.14-0.24) and 0.25 AU (IQR 0.20-0.29), respectively.
Conclusion
Surprisingly, we found hyperactive small bowel motility in half of the CIPO patients, suggestive of uncoordinated intestinal motility. Quantitation showed a wide variation in motility patterns, with both higher and lower motility than in healthy subjects, and an absence of postprandial activation. Dynamic MRI helps to gain insight into this complex disease and can potentially impact treatment decisions in the future.