Impact of bowel dilation on small bowel motility measurements with cine-MRI: assessment of two quantification techniques

OBJECTIVES: To evaluate the effect of bowel dilation on cine-MRI small bowel motility measurements, by comparing a conventional motility score (including bowel wall and lumen) with a bowel wall-specific motility score in healthy and diseased populations.

METHODS: Four populations were included: 10 Crohn's patients with a stricture and prestricture dilation for segmental motility analysis, and 14 mannitol-prepared healthy subjects, 15 fasted healthy subjects and eight chronic intestinal pseudo-obstruction (CIPO) patients (characterized by dilated bowel loops) for global small bowel motility analysis. All subjects underwent a cine-MRI scan from which two motility scores were calculated: a conventional score (including bowel wall and lumen) and a bowel wall-specific score. The difference between the two scores was calculated per population and compared between groups with a one-way ANOVA and Tukey-Kramer analysis.

RESULTS: In Crohn's patients, the median (IQR) change between the conventional and wall-specific motility score was 0% (-2 to +4%) within the stricture and 0% (-1 to +7%) in the prestricture dilation. For the global small bowel, this was -1% (-5 to 0%) in mannitol-prepared healthy subjects, -2% (-6 to +2%) in fasted healthy subjects and +14% (+6 to+20%) in CIPO patients. The difference between the two motility scores in CIPO patients differed significantly from the four other groups (p = 0.002 to p < 0.001).

CONCLUSIONS: The conventional small bowel motility score seems robust in Crohn's disease patients and healthy subjects. In patients with globally and grossly dilated bowel loops, a bowel-wall specific motility score may give a better representation of small bowel motility.

ADVANCES IN KNOWLEDGE: These findings support researchers and clinicians with making informed choices for using cine-MRI motility analysis in different populations.