Menys, A; Plumb, A; Atkinson, D; Taylor, S; (2014) The challenge of segmental small bowel motility quantitation using Magnetic Resonance Enterography. Br J Radiol , 87 (1040) , Article 20140330. 10.1259/bjr.20140330.

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Abstract

Background Analysis of 'cine' MRI using segmental regions of interest (ROI) has become increasingly popular for investigating bowel motility however variation in healthy subjects motility both within and between scans remains poorly described. Methods 20 healthy individuals (mean age 28, 14 male) underwent Magnetic Resonance Enterography to acquire dynamic motility scans in both breath-hold (BH) and free-breathing (FB) on two occasions. Motility data was quantitatively assessed by placing 4 ROIs per subject in different small bowel segments and applying two measures 1)Contractions per minute (CPM) and 2) Jacobian SD (Jacobian Standard Deviation) motility score. Within-scan (between segment) variation was assessed using Intra-class correlation (ICC) and repeatability was assessed using Bland-Altman Limits of Agreement (BA LoA). Key Results Within-scan segmental variation: Breath hold CPM and Jacobian SD metrics between the 4 segments demonstrated ICC R=0.06, p=0.1 and R=0.2, p=0.027 and in Free-breathing data ICC R=-0.26, p=0.05 and R=0.19, p=0.03. Repeatability: Breath hold CPM for matched segments ranged between 0 and 14 contractions with BA LoA of ±8.36, Jacobian SD ranged between 0.09 to 0.51 with LoA ±0.33. In free-breathing data CPM ranged between 0 and 10 contractions with BA LoA of ±7.25, Jacobian SD ranged between 0.16 to 0.63 with LoA = ±0.28. Conclusion & Inferences MRI quantified small bowel motility in normal subjects demonstrates wide inter-segmental variation and relatively poor repeatability over time. Advances in Knowledge This paper presents baseline values for healthy individuals within and between-scan motility essential for understanding how this process changes in disease.

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