Abstract
Increasingly, dynamic magnetic resonance imaging (MRI) has potential as a noninvasive and accessible tool for diagnosing and monitoring gastrointestinal motility in healthy and diseased bowel. However, current MRI methods of measuring bowel motility have limitations: requiring bowel preparation or long acquisition times; providing mainly surrogate measures of motion; and estimating bowel-wall movement in just two dimensions. In this proof-of-concept study we apply a method that provides a quantitative measure of motion within the bowel, in both two and three dimensions, using existing, vendor-implemented MRI pulse sequences with minimal bowel preparation. This method uses a minimised cost function to fit linear vectors in the spatial and temporal domains. It is sensitised to the spatial scale of the bowel and aims to address issues relating to the low signal-to-noise in high-temporal resolution dynamic MRI scans, previously compensated for by performing thick-slice (10-mm) two-dimensional (2D) coronal scans. We applied both 2D and three-dimensional (3D) scanning protocols in two healthy volunteers. For 2D scanning, analysis yielded bi-modal velocity peaks, with a mean antegrade motion of 5.5 mm/s and an additional peak at ~9 mm/s corresponding to longitudinal peristalsis, as supported by intraoperative data from the literature. Furthermore, 3D scans indicated a mean forward motion of 4.7 mm/s, and degrees of antegrade and retrograde motion were also established. These measures show promise for the noninvasive assessment of bowel motility, and have the potential to be tuned to particular regions of interest and behaviours within the bowel.
Highlights
Bowel motility disorders can arise from several conditions and affect patients to varying degrees across a wide demographic
Crohn's disease affects growth in children,[4] and has serious long-term implications, while ulcerative colitis is associated with a high risk of colon cancer.[5]
In this work we introduce a new method for quantifying bowel motility and velocity in two and three dimensions. The benefits of this method are as follows: (1) it provides a quantitative measure of motion within the bowel, as well as of the bowel itself; (2) it can be performed using off-theshelf Magnetic resonance imaging (MRI) sequences; (3) it can be applied in three dimensions to better track bowel anatomy; and (4) it complements existing surrogate measures in a manner that will enhance the field
Summary
Bowel motility disorders can arise from several conditions and affect patients to varying degrees across a wide demographic. Inflammatory bowel conditions, such as Crohn's disease[1] and ulcerative colitis,[2] are often associated with bowel motility disorders.[3] Crohn's disease affects growth in children,[4] and has serious long-term implications, while ulcerative colitis is associated with a high risk of colon cancer.[5] Globally these two conditions affect more than 11 million people,[6] with the causes being poorly understood. Causes of IBS range from psychological stress[9] to bacterial aetiology[10] and vitamin deficiency.[11]
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