Colon length in pediatric health and constipation measured using magnetic resonance imaging and three dimensional skeletonization

Sharif, Hayfa; Hoad, Caroline L.; Abrehart, Nichola; Gowland, Penny A.; Spiller, Robin C.; Kirkham, Sian; Loganathan, Sabarinathan; Papadopoulos, Michalis; Benninga, Marc A.; Devadason, David; Marciani, Luca

Abstract

Recent magnetic resonance imaging (MRI) studies showed that colonic volumes in children are different between health and functional constipation. The length of the colon has however been rarely measured and principally using unphysiological colon preparations or cadaver studies. The main objective of this study was to measure the length of the undisturbed colon in children with functional constipation (FC) and healthy controls. Here, the colon of 19 healthy controls (10-18 years old) and 16 children with FC (7-18 years old) was imaged using MRI. Different regions of the colon (ascending, transverse, descending, and sigmoid-rectum) were first segmented manually on the MRI images. Three-dimensional skeletonization image analysis methods were then used to reduce the regions of interest to a central, measurable line. Total colon length (corrected for body surface area) in healthy controls was 56±2 cm/m2 (mean±SEM). Total colon length was significantly longer in children with FC 69±3 cm/m2 compared to controls (p = 0.0037). The colon regions showing the largest differences between groups were the ascending colon (p = 0.0479) and the sigmoid-rectum (p = 0.0003). In a linear regression model, there was a positive significant correlation between total colon length and age (R = 0.45, p = 0.0064), height (R = 0.49, p = 0.0031), weight (R = 0.46, p = 0.0059) and colon volume (R = 0.4543, p = 0.0061). Our findings showed significant differences in colon lengths between healthy controls and children with constipation. A new objective diagnostic imaging endpoint such as colon length may help to improve knowledge of colon morphology and function and, in turn, understanding of colon functional pathology.

Citation

Sharif, H., Hoad, C. L., Abrehart, N., Gowland, P. A., Spiller, R. C., Kirkham, S., …Marciani, L. (2024). Colon length in pediatric health and constipation measured using magnetic resonance imaging and three dimensional skeletonization. PLoS ONE, 19(1), Article e0296311. https://doi.org/10.1371/journal.pone.0296311

• Journal Article Type: Article
• Acceptance Date: Dec 9, 2023
• Online Publication Date: Jan 2, 2024
• Publication Date: Jan 2, 2024
• Deposit Date: Jan 3, 2024
• Publicly Available Date: Jan 3, 2024
• Journal: PLOS ONE
• Electronic ISSN: 1932-6203
• Publisher: Public Library of Science
• Peer Reviewed: Peer Reviewed
• Volume: 19
• Issue: 1
• Article Number: e0296311
• DOI: https://doi.org/10.1371/journal.pone.0296311
• Keywords: Multidisciplinary
• Public URL: https://nottingham-repository.worktribe.com/output/29266130
• Publisher URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0296311
• Additional Information: © 2024 Sharif et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.