Global small bowel motility: assessment with dynamic MR imaging

Radiology. 2013 Nov;269(2):443-50. doi: 10.1148/radiology.13130151. Epub 2013 Jun 25.

Abstract

Purpose: To assess the repeatability in human volunteers of software-quantified small bowel motility captured with magnetic resonance (MR) imaging and to test the ability to detect changes in motility induced by pharmacologic agents.

Materials and methods: The study was approved by the Royal Free Research Ethics Committee, and all subjects gave full written informed consent. Twenty-one healthy volunteers (14 men, seven women; mean age, 28 years) underwent cine MR imaging with a three-dimensional balanced turbo field-echo sequence to capture small bowel motility. Volume blocks (15 cm thick) were acquired every second during a 20-second breath hold. A randomized, blinded, placebo-controlled crossover study of either 0.5 mg neostigmine or saline (n = 11) or 20 mg intravenous butylscopolamine or saline (n = 10) was performed with motility MR imaging at baseline and repeated at a mean of 4 weeks (range, 2-7 weeks). Two readers independently drew regions of interest around the small bowel, and motility was quantified by using a registration algorithm that provided a global motility metric in arbitrary units. Repeatability of the motility measurements at baseline was assessed by using Bland-Altman and within-subject coefficient of variation measures. Changes in mean motility measurements after drug administration were compared with those after placebo administration by using paired t testing.

Results: The repeatability between baseline measurements of motility was high; the Bland-Altman mean difference was -0.0025 (range, 0.28-0.4), the 95% limit of agreement was ±0.044 arbitrary units (au), and the within-subject coefficient of variation was 4.9%. Measured motility with neostigmine (mean, 0.39 au) was significantly higher than that with placebo (mean, 0.34 au; P < .001), whereas that with butylscopolamine (mean, 0.13 au) was significantly lower than that with placebo (mean, 0.30 au; P < .001).

Conclusion: Quantification of small bowel motility with use of MR imaging in healthy volunteers is repeatable and sensitive to changes induced by means of pharmacologic manipulation.

Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.13130151/-/DC1.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Algorithms
  • Butylscopolammonium Bromide / administration & dosage
  • Butylscopolammonium Bromide / pharmacology*
  • Cross-Over Studies
  • Female
  • Gastrointestinal Motility / drug effects*
  • Humans
  • Imaging, Three-Dimensional
  • Intestine, Small*
  • Magnetic Resonance Imaging, Cine / methods*
  • Male
  • Neostigmine / administration & dosage
  • Neostigmine / pharmacology*
  • Parasympatholytics / administration & dosage
  • Parasympatholytics / pharmacology*
  • Parasympathomimetics / administration & dosage
  • Parasympathomimetics / pharmacology*
  • Placebos
  • Reproducibility of Results

Substances

  • Parasympatholytics
  • Parasympathomimetics
  • Placebos
  • Butylscopolammonium Bromide
  • Neostigmine