title: Clinical importance of cine-MRI assessment of small bowel motility in patients with chronic intestinal pseudo-obstruction: a retrospective study of 33 patients.
abstract: BACKGROUND
  Although chronic intestinal pseudo-obstruction (CIPO) is a rare and extremely severe functional digestive disorder, its clinical course and severity show various patterns. We assessed small bowel peristalsis in CIPO patients using cine-MRI (video-motion MRI) and their clinical characteristics to evaluate the clinical importance of performing cine-MRI in patients with this intractable disease.
  
  
  METHODS
  The medical records of 131 patients referred to our institution with a suspected diagnosis of CIPO between 2010 and 2015 were retrospectively evaluated. Thirty-three patients (22 female/11 male; age range 16-79 years) who met the criteria for CIPO and underwent cine-MRI were enrolled. Mean luminal diameter (MLD), contraction ratio (CR), and contraction cycle (CC) were determined and compared with these parameters in healthy volunteers. Clinical outcomes in patients with CIPO were also evaluated.
  
  
  RESULTS
  The median follow-up time was 25.2 months (range, 1-65 months). Of the 33 patients with CIPO, 23 (70 %) showed apparently disturbed small intestinal peristalsis, whereas 10 (30 %) did not. The percentage of patients requiring intravenous alimentation was significantly higher (p = 0.03), and the mean serum albumin level was significantly lower (p = 0.04), in patients with than without impaired small intestinal peristalsis. Although both cine-MRI and CT findings in the latter ten cases were within the normal range, MLD and CR differed significantly from healthy volunteers.
  
  
  CONCLUSIONS
  Cine-MRI is useful in predicting severe clinical features in patients with CIPO, and in detecting slightly impaired small contractility that cannot be detected on CT.
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Fuyuki
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Ohkubo
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan.
authors.forename: Takuma
authors.initials: T
authors.lastname: Higurashi
authors.affiliation: Department of Medical Education, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iida
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Inoh
authors.affiliation: Department of Medical Education, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inamori
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan. nakajima-tky@umin.ac.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000503:physiopathology; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D008297:Male; D008875:Middle Aged; D010528:Peristalsis / Q000502:physiology; D012189:Retrospective Studies; D014741:Video Recording / Q000379:methods; D055815:Young Adult
keywords: Chronic intestinal pseudo-obstruction; Cine-MRI; Small bowel peristalsis