title: Is there a role for dynamic swallowing MRI in the assessment of gastroesophageal reflux disease and oesophageal motility disorders?
abstract: OBJECTIVE
  To evaluate the diagnostic value of dynamic MRI swallowing in patients with symptoms of Gastroesophageal Reflux Disease (GERD).
  
  
  METHODS
  Thirty-seven patients (17 m/20f) with typical signs of GERD underwent MR swallowing in the supine position at 1.5 T with a phased-array body coil. Using dynamic, gradient echo sequences (B-FFE) in the coronal, sagittal and axial planes, the bolus passages of buttermilk spiked with gadolinium chelate were tracked. MRI, pH-metry and manometry were performed within 31 days and results were compared.
  
  
  RESULTS
  MRI results were concordant with pH-metry in 82% (23/28) of patients diagnosed with abnormal oesophageal acid exposure by pH-metry. Five patients demonstrated typical symptoms of GERD and had positive findings with pH monitoring, but false negative results with MRI. In four of six patients (67%), there was a correct diagnosis of oesophageal motility disorder, according to manometric criteria, on dynamic MRI. The overall accuracy of MRI diagnoses was 79% (27/34). A statistically significant difference was found between the size of hiatal hernia, grade of reflux in MRI, and abnormal acid exposure on pH-monitoring.
  
  
  CONCLUSIONS
  MR fluoroscopy may be a promising radiation-free tool in assessing the functionality and morphology of the GE junction.
  
  
  CONCLUSIONS
  • Swallowing MRI can assess anatomy and function of the gastroesophageal-junction • Swallowing MRI can help identifying reflux and motility disorders • Definition of the size of hiatal hernias is possible in all three planes in MR. • Short duration of swallowing MRI enables its application in routine clinical practice.
authors: Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. Christiane.Kulinna-Cosentini@meduniwien.ac.at
authors: Christiane
authors: C
authors: Kulinna-Cosentini
authors: W
authors: W
authors: Schima
authors: J
authors: J
authors: Lenglinger
authors: M
authors: M
authors: Riegler
authors: C
authors: C
authors: Kölblinger
authors: A
authors: A
authors: Ba-Ssalamah
authors: G
authors: G
authors: Bischof
authors: M
authors: M
authors: Weber
authors: P
authors: P
authors: Kleinhansl
authors: E P
authors: EP
authors: Cosentini
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002614:Chelating Agents / Q000494:pharmacology; D003287:Contrast Media / Q000494:pharmacology*; D043302:Cultured Milk Products; D003679:Deglutition; D015154:Esophageal Motility Disorders / Q000175:diagnosis / Q000473:pathology*; D050782:Esophageal pH Monitoring; D005260:Female; D005682:Gadolinium / Q000494:pharmacology; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D016683:Supine Position
chemical_list: D002614:Chelating Agents; D003287:Contrast Media; D005682:Gadolinium