title: Assessment of small bowel motility in patients with chronic intestinal pseudo-obstruction using cine-MRI.
abstract: OBJECTIVE
  Chronic intestinal pseudo-obstruction (CIPO) is a rare, serious motility disorder, with life-threatening complications over time. However, lack of an established, non-invasive diagnostic method has caused delays in the diagnosis of this intractable disease. Cine-magnetic resonance imaging (MRI) is an emerging technique, with a potential to evaluate the motility of the entire bowel. We compared small bowel motility in healthy volunteers, patients with irritable bowel syndrome (IBS), and those with CIPO, using cine-MRI, and evaluated the usefulness of cine-MRI as a novel diagnostic method for CIPO.
  
  
  METHODS
  Twelve healthy volunteers, IBS patients, and CIPO patients prospectively underwent cine-MRI at 1.5 T. Luminal diameter, contraction ratio, and contraction cycle were measured and compared between the groups.
  
  
  RESULTS
  Cine-MRI provided sufficient dynamic images to assess the motility of the entire small bowel. Luminal diameter (mean±s.d.) in CIPO patients was significantly higher than that in healthy volunteers and IBS patients (43.4±14.1, 11.1±1.5, and 10.9±1.9 mm, respectively), and contraction ratio was significantly lower in CIPO patients than that in healthy volunteers and IBS patients (17.1±11.0%, 73.0±9.3%, and 74.6±9.4%, respectively). No significant differences were observed in the contraction cycle.
  
  
  CONCLUSIONS
  This study is the first to assess the clinical utility of cine-MRI in CIPO patients. Cine-MRI clearly detected contractility impairments in CIPO patients. Cine-MRI is noninvasive, radiation-free, and can directly evaluate the entire small bowel peristalsis, and can detect the affected loops at a glance; therefore, it might be extremely useful for the diagnosis and follow-up of CIPO patients in clinical practice.
authors.affiliation: Gastroenterology Division, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Ohkubo
authors.forename: Takaomi
authors.initials: T
authors.lastname: Kessoku
authors.forename: Akiko
authors.initials: A
authors.lastname: Fuyuki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iida
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inamori
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Fujii
authors.forename: Harunobu
authors.initials: H
authors.lastname: Kawamura
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hata
authors.forename: Noriaki
authors.initials: N
authors.lastname: Manabe
authors.forename: Toshimi
authors.initials: T
authors.lastname: Chiba
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Kwee
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Matsuhashi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
authors.forename: Taro
authors.initials: T
authors.lastname: Takahara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000175:diagnosis* / Q000503:physiopathology*; D007421:Intestine, Small / Q000503:physiopathology*; D043183:Irritable Bowel Syndrome / Q000503:physiopathology*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D009130:Muscle, Smooth / Q000503:physiopathology