Cine MRI assessment of motility in the unprepared small bowel in the fasting and fed state: beyond the breath-hold

Hoad, Caroline; Marciani, Luca; Spiller, Robin; Gowland, Penny; Moran, Gordon

Abstract

Background

The symptoms of functional bowel disorders are common in postprandial but investigations are generally undertaken in the fasted state using invasive procedures. MRI provides a noninvasive tool to study the gastrointestinal tract in an unperturbed, fed state. The aim of this study was to develop a technique to assess small bowel motility from cine MRI data in the unprepared bowel in fasting and fed states.

Methods

Fifteen healthy volunteers underwent a baseline MRI scan after which they consumed a 400 g soup. Subjects then underwent a postprandial scan followed by further scans at regular intervals. Small bowel motility was assessed using single‐slice bTFE cine MRI. An optimized processing technique was used to generate motility data based on power spectrum analysis of voxel‐signal changes with time. Interobserver variability (n = 15) and intra‐observer (n = 6) variability were assessed. Changes in the motility index were compared between fasted and immediate postprandial state.

Key Results

Excellent agreement between observers was seen across the range of motility measurements acquired, with intraclass correlation coefficient (ICC) of 0.979 (P [less than] 0.0001) and Bland‐Altman limits of agreement 95% CI: −28.9 to 45.9 au. Intra‐observer variability was low with ICC of 0.992 and 0.960 (2 observers, P [less than] 0.0001). Changes from the fasted to immediately postprandial state showed an average increase of 122.4% ± 98.7% (n = 15).

Conclusions & Inferences

This optimized technique showed excellent inter and intra observer agreement. It was sensitive to changes in motility induced feeding. This technique will be useful to study contractile activity and regional patterns along the gastrointestinal tract under physiological conditions.

Citation

Hoad, C., Marciani, L., Spiller, R., Gowland, P., & Moran, G. (2019). Cine MRI assessment of motility in the unprepared small bowel in the fasting and fed state: beyond the breath-hold. Neurogastroenterology and Motility, 31(1), e13466. https://doi.org/10.1111/nmo.13466

• Journal Article Type: Article
• Acceptance Date: Aug 14, 2018
• Online Publication Date: Sep 19, 2018
• Publication Date: 2019-01
• Deposit Date: Sep 12, 2018
• Publicly Available Date: Sep 20, 2019
• Journal: Neurogastroenterology and Motility
• Electronic ISSN: 1350-1925
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 31
• Issue: 1
• Article Number: e13466
• Pages: e13466
• DOI: https://doi.org/10.1111/nmo.13466
• Public URL: https://nottingham-repository.worktribe.com/output/1069610
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1111/nmo.13466
• Additional Information: This is the peer reviewed version of the following article: Khalaf A, Nowak A, Menys A, et al. Cine MRI assessment of motility in the unprepared small bowel in the fasting and fed state: Beyond the breath‐hold. Neurogastroenterol Motil. 2018;00:e13466. https://doi.org/10.1111/nmo.13466, which has been published in final form at https://onlinelibrary.wiley.com/action/showCitFormats?doi=10.1111%2Fnmo.13466. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
• Contract Date: Sep 12, 2018