New cine magnetic resonance imaging parameters for the differential diagnosis of chronic intestinal pseudo-obstruction

Hiroki Sato,Kentaro Tominaga,Yuzo Kawata,Yoshihiko Hamamoto,Kazuya Takahashi,Hiroyuki Ogihara,Shuji Terai,Junji Yokoyama,Yuichi Kojima

doi:10.1038/s41598-021-02268-1

Hiroki Sato, Kentaro Tominaga + Show 7 more

Open Access

https://doi.org/10.1038/s41598-021-02268-1

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Journal: Scientific Reports	Publication Date: Nov 26, 2021
Citations: 3	License type: open-access

Affiliation: Niigata University, Yamaguchi University

Abstract

Chronic intestinal pseudo-obstruction (CIPO) is a severe and refractory intestinal motility disorder whose diagnosis currently relies on subjective imaging assessments. Cine magnetic resonance imaging (MRI) may potentially improve the quantitative analysis of gastrointestinal motility; however, suitable CIPO detection parameters should be determined. Cine MRI was performed in seven patients with CIPO and 11 healthy controls. The logarithm of the Mahalanobis distance (x1) and distance variation per time (x2) were used as the original parameters to determine CIPO diagnostic thresholds. Furthermore, the correlation between cine MRI findings and CIPO severity was investigated. Threshold values of α = 1.10 and β = 0.15 for x1 and x2, respectively, produced a CIPO diagnosis sensitivity of 1.00 (7/7) and specificity of 0.82 (9/11). The resulting error was 0.11 (2/18). The two parameters were correlated (Pearson’s correlation coefficient: − 0.52). Any of the intestinal tracts of patients with severe CIPO requiring home parenteral nutrition belonged to the region defined by x1 ≥ 1.10 and x2 ≤ 0.15. Cine MRI is effective for the quantitative evaluation of small intestinal motility and CIPO diagnosis when using the abovementioned parameters and can be useful for treatment decision-making. However, these parameters have a wide distribution in healthy volunteers; this may complicate the detection of other disorders.

Highlights

Chronic intestinal pseudo-obstruction (CIPO) is a severe and refractory intestinal motility disorder whose diagnosis currently relies on subjective imaging assessments
Patients who require resection of the intestine risk developing adhesive ileus or short bowel syndrome when extensive resection of the small intestine is performed. If their symptoms become more severe owing to intestinal motility failure, or malabsorption occurs owing to short bowel syndrome, home parenteral nutrition (HPN) becomes necessary to supplement n ourishment[2]
Cine magnetic resonance imaging (MRI) examination was performed on 11 healthy volunteers comprising six men (54.5%) and five women (45.5%) with an age of 35 (29.0–41.5) years

Summary

Introduction

Chronic intestinal pseudo-obstruction (CIPO) is a severe and refractory intestinal motility disorder whose diagnosis currently relies on subjective imaging assessments. Cine MRI is effective for the quantitative evaluation of small intestinal motility and CIPO diagnosis when using the abovementioned parameters and can be useful for treatment decision-making. These parameters have a wide distribution in healthy volunteers; this may complicate the detection of other disorders. Patients who require resection of the intestine risk developing adhesive ileus or short bowel syndrome when extensive resection of the small intestine is performed If their symptoms become more severe owing to intestinal motility failure, or malabsorption occurs owing to short bowel syndrome, home parenteral nutrition (HPN) becomes necessary to supplement n ourishment[2]. The inter- and intra-observer discrepancy remains a hindrance for objective diagnosis

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