Distinct Abnormalities of Small Bowel and Regional Colonic Volumes in Subtypes of Irritable Bowel Syndrome Revealed by MRI

Lam, Ching; Chaddock, Gemma; Laurea, Luca Marciani; Costigan, Carolyn; Cox, Eleanor; Hoad, Caroline L.; Pritchard, Susan E.; Gowland, Penny; Spiller, Robin C.

doi:10.1038/ajg.2016.538

Cited by 33 publications

(30 citation statements)

References 24 publications

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“…13,14 Additionally, chyme heterogeneity in the ascending colon has been assessed with subjective observer scores, 13 and more objectively with imaging-based feature analysis. 15 Colonic segmental volumes can be quantified from T 2 -weighted MRI sequences, where the colon wall shows high contrast to surrounding fat tissue, [16][17][18][19] a method with high reliability between observers. 20 T 2 -weighted MRI has also been used to quantify the amount of free water pockets in the small bowel and colon after drinking water, due to the images' high signal strength corresponding to free water.…”

mentioning

confidence: 99%

MRI analysis of fecal volume and dryness: Validation study using an experimental oxycodone‐induced constipation model

Mark

Bodker

Grønlund

et al. 2019

Magnetic Resonance Imaging

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Background Opioids are known to affect gastrointestinal motility, but their effect on fluid absorption and secretion is poorly understood in humans. Purpose To investigate the effect of oxycodone on colonic fecal volume and stool dryness by using a novel MRI‐based technique. Study Type Prospective, randomized, double‐blinded, crossover study. Subjects Twenty‐five healthy male volunteers (median age: 24 years [range: 21–56]; mean body mass index [BMI]: 23.9 kg/m2 [range: 22.9–25.0]) without known gastrointestinal disease. Field Strength/Sequence T2‐weighted and two‐point Dixon MRI scans of the abdomen at 1.5 T. Assessment Subjects were treated for 5 days with prolonged‐release oxycodone or a placebo. Imaging was performed on the first and last study day in each period. Images of the colon were analyzed with semiautomatic k‐means‐based segmentation software. Regional colonic fecal volumes were quantified excluding gas volume and colon wall. Two‐point Dixon and T2‐weighted MRI signal intensity were assessed as a proxy of colonic stool dryness. Data were obtained in a previously reported study. Statistical Tests Intraclass correlation coefficients were used to test the reliability of measurements between days, while repeated measures mixed models were applied to test treatment effects. Results After oxycodone treatment, total colonic fecal volume was significantly increased compared with placebo (mean change 100 mL vs. –13 mL; P = 0.001), with the largest increase (24%) observed in the ascending colon/cecum (P = 0.001). Dixon signal increased (less water in colon content) after oxycodone treatment compared with placebo (mean 0.09 vs. –0.02; P < 0.001). T2‐weighted signal decreased (less water in colon content) after oxycodone treatment compared with placebo (mean –0.03 vs. 0.03; P = 0.002). Data Conclusion The 5‐day oxycodone treatment increased colonic fecal volume and increased stool dryness compared with placebo. This imaging‐based method for noninvasive analysis of colon content has the potential to characterize gastrointestinal symptoms in general, such as in constipation. Level of Evidence: 2 Technical Efficacy Stage: 1 J. Magn. Reson. Imaging 2019;50:733–745.

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confidence: 99%

MRI analysis of fecal volume and dryness: Validation study using an experimental oxycodone‐induced constipation model

Mark

Bodker

Grønlund

et al. 2019

Magnetic Resonance Imaging

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“…An additional advantage of MRI is that a number of parameters of GI motor function can be derived from a single MRI study of a patient, some of which would otherwise require separate techniques and appointments. In addition to GI transit time, MRI can visualise anatomy, measure colonic volume, colonic wall movement (motility), freely mobile water content, chyme relaxometry, gas content and abnormalities of colonic wall thickness [73,74,80,81]. Recently, the MRI tagging technique helped to visualise the movement of colonic chyme in subjects with and without constipation [12].…”

Section: Discussionmentioning

confidence: 99%

“…An interesting Single-photon Emission Computed Tomography/ Magnetic Resonance The MRI capsules method was applied in studies of adult constipation, whereby whole gut transit measured by MRI was significantly slower for patients with functional constipation compared with healthy controls (p < 0.01) [73], and for irritable bowel syndrome with constipation compared with healthy controls (p < 0.01 [73] and p < 0.03 [74]). Similarly, in another study healthy volunteers swallowed 5 MRI marker capsules (overall outer dimensions 23.9 mm × 6.0 mm) containing a saline water solution doped with gadolinium contrast agent [75].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Imaging Measurement of Whole Gut Transit Time in Paediatric and Adult Functional Gastrointestinal Disorders: A Systematic Review and Narrative Synthesis

et al. 2019

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Background: functional gastrointestinal disorders (FGID) are common conditions in children and adults, often associated with abnormalities of whole gut transit. Currently, transit tests can be performed using several imaging methods, including tracking of radiopaque markers, gamma scintigraphy with the use of radioisotopes, magnetic tracking methods, tracking of movement of wireless motility capsules, and emerging magnetic resonance imaging (MRI) approaches. Objectives: to review recent literature on diagnostic imaging techniques used to investigate whole gut transit in FGIDs. Methods: a systematic review was carried out. The different techniques are described briefly, with particular emphasis on contemporary literature and new developments, particularly in the field of MRI. Conclusions: emerging MRI capsule marker methods are promising new tools to study whole gut transit in FGIDs.Small intestinal bacterial overgrowth (SIBO) is another common disorder of the gastrointestinal tract. It reflects excess presence of bacteria in the small bowel, and recent studies suggest SIBO can be associated with altered gut transit [6].Constipation can be caused by slow transit of chyme within the colon. Different factors can contribute to this, including diet, lifestyle and medications [7]. Constipation can also signal the presence of other underlying disorders such as diabetes, coeliac disease and cancer [8].A recent review estimated the average prevalence of constipation at 16% worldwide [9]. In the United States, the number of hospital emergency visits linked to constipation increased by 41.5% between 2006 and 2011 [10]. Constipation is thought to be twice as common in women than in men [9]. Women at the postpartum stage (several weeks after pregnancy) are often affected by the condition, with up to 25% of women reporting the incidence of constipation [11]. Constipation rates tend to be substantially higher in the elderly population and reach up to 50-75%.Most cases of constipation are caused by one of three general mechanisms: disordered and obstructed defecation caused primarily by impaired rectal evacuation, irritable bowel syndrome with constipation, and slow transit constipation [12]. These mechanisms differ substantially, even though the general symptoms of constipation appear very similar. Proper treatment in each case calls for a patient-specific differential diagnosis. This diagnosis remains challenging and about half of all patients who complain of constipation remain unsatisfied with the treatment they receive [12].Slow transit constipation, a reduced intestine motility caused by abnormalities of the enteric nerves, accounts for 15-30% of all constipated patients, with up to 37% of constipated women affected [13].Functional constipation in childhood is very common. Its prevalence has been estimated to be 14%, forming approximately 3% of all hospital paediatric referrals [14][15][16][17][18]. In the majority of paediatric cases, constipation is not linked to specific clinical disorders but rather caused by changes i...

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“…Prospective comparative study of MRI versus CT or US would give more information of the diagnostic potential of these imaging modalities in chronic NSAP. Objective assessments of the gastric, small bowel, and colonic regional volumes are possible using MRI, and unique data emphasizing the differences in gut volumes and motility related to chronic pain syndrome may be now possible [32,33]. Finally, we did not test cost-effectiveness of MRI in NSAP because we were more interested in additional diagnostic potential of MRI in chronic pain syndrome.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Potential of Magnetic Resonance Imaging in Chronic Abdominal Pain

et al. 2019

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Introduction: About half of the adult patients suffering from chronic abdominal pain may have no organ-related cause. Our purpose was to evaluate the additional information of magnetic resonance imaging (MRI) in diagnosing the underlying organic causes of such pain. Methods: We performed retrospective audit of 636 consecutive abdominal MRI in patients suffering from nonspecific abdominal pain (NSAP) during years 2014-2017. Medical history, clinical examination, endoscopy reports, and the results of MRI were compared in all patients. The hypothesis was that MRI increases markedly the diagnostic specificity of patients' symptoms. Results: The mean age of patients was 66 ± 14 years and 60 percent were females. Duration of abdominal pain ranged from 1 month to 30 years (median 1.1 ± 4.0 years). Concurrently with abdominal MRI (n = 636), also ultrasound (n = 106, 17%), colonoscopy (n = 222, 35%), and gastroscopy (n = 217, 34%) were performed. Abdominal MRI revealed additional information in 161/636 (25%) of NSAP patients. Spinal and pelvic bone abnormalities (n = 107) and malignant tumors (n = 31) were the most significant organ-specific findings changing the treatment algorithm. Conclusions: When computerized tomography is not available in outpatient clinics, abdominal MRI increases markedly diagnostic specificity and alters the treatment in 1 of 4 patients suffering from NSAP. Abdominal MRI is therefore suggested for patients suffering from severe symptoms of NSAP.

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Distinct Abnormalities of Small Bowel and Regional Colonic Volumes in Subtypes of Irritable Bowel Syndrome Revealed by MRI

Cited by 33 publications

References 24 publications

MRI analysis of fecal volume and dryness: Validation study using an experimental oxycodone‐induced constipation model

MRI analysis of fecal volume and dryness: Validation study using an experimental oxycodone‐induced constipation model

Imaging Measurement of Whole Gut Transit Time in Paediatric and Adult Functional Gastrointestinal Disorders: A Systematic Review and Narrative Synthesis

Diagnostic Potential of Magnetic Resonance Imaging in Chronic Abdominal Pain

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