title: The effect of gastric secretion on gastric physiology and emptying in the fasted and fed state assessed by magnetic resonance imaging.
abstract: Conventional measurement of gastric secretion is invasive and cannot assess the intra-gastric distribution of gastric contents or the effects of secretion on gastric function. This study assessed the effect of gastric secretion on gastric volume responses and emptying (GE) using a validated fast T(1) mapping magnetic resonance imaging (MRI) technique. Twelve healthy participants were studied in the fasted state and after 200 kcal Gadolinium-DOTA labelled glucose meal during intravenous infusion of pentagastrin or placebo in double-blind, randomized order. Total gastric volume (TGV) and gastric content volume (GCV) was assessed by MRI volume scans and secretion by fast T(1) mapping. Data was described by the kappa-coefficient (volume change after meal ingestion), by GE half time (T(50)) and maximal GE rate (GER(max)) derived all from a GE model. Pentagastrin increased GCV and TGV compared to placebo [kappa(GCV):1.6 +/- 0.1 vs 0.6 +/- 0.1; kappa(TGV): 1.6 +/- 0.1 vs 0.7 +/- 0.1; P < 0.001]. T(1) maps revealed a secretion layer above the meal, the volume of which was associated with kappa (R(2) = 83%, P < 0.001). TGV and GCV change were similar in both conditions (kappa; P = ns). T(50) was higher for pentagastrin than for placebo (84 +/- 7 vs 56 +/- 4min, P < 0.001); however, GER(max) was similar (5.9 +/- 0.6 vs 4.9 +/- 0.4 mL min(-1), P = ns). This study shows volume and distribution of gastric secretion can be quantified in-vivo by non-invasive MRI T(1) mapping. Increased GCV drove TGV accommodation without evidence of a direct effect of pentagastrin or excess acid on gastric function. Secretion increases GCV thus prolongs GE as assessed by T(50); however, GE rate is unchanged.
authors.affiliation: Division of Gastroenterology, University Hospital Zurich, Zurich, Switzerland. oliver.goetze@usz.ch
authors.forename: O
authors.initials: O
authors.lastname: Goetze
authors.forename: R
authors.initials: R
authors.lastname: Treier
authors.forename: M
authors.initials: M
authors.lastname: Fox
authors.forename: A
authors.initials: A
authors.lastname: Steingoetter
authors.forename: M
authors.initials: M
authors.lastname: Fried
authors.forename: P
authors.initials: P
authors.lastname: Boesiger
authors.forename: W
authors.initials: W
authors.lastname: Schwizer