Quantification and variability in colonic volume with anovel magnetic resonance imaging method.

Abstract

Segmental distribution of colorectal volume is relevant in a number of diseases, but clinical and experimental use demands robust reliability and validity. Using a novel semi-automatic magnetic resonance imaging-based technique, the aims of this study were to describe: (i) inter-individual and intra-individual variability of segmental colorectal volumes between two observations in healthy subjects and (ii) the change in segmental colorectal volume distribution before and after defecation. The inter-individual and intra-individual variability of four colorectal volumes (cecum/ascending colon, transverse, descending, and rectosigmoid colon) between two observations (separated by 52±10) days was assessed in 25 healthy males and the effect of defecation on segmental colorectal volumes was studied in another seven healthy males. No significant differences between the two observations were detected for any segments (All p>0.05). Inter-individual variability varied across segments from low correlation in cecum/ascending colon (intra-class correlation coefficient [ICC]=0.44) to moderate correlation in the descending colon (ICC=0.61) and high correlation in the transverse (ICC=0.78), rectosigmoid (ICC=0.82), and total volume (ICC=0.85). Overall intra-individual variability was low (coefficient of variance=9%). After defecation the volume of the rectosigmoid decreased by 44% (p=0.003). The change in rectosigmoid volume was associated with the true fecal volume (p=0.02). Imaging of segmental colorectal volume, morphology, and fecal accumulation is advantageous to conventional methods in its low variability, high spatial resolution, and its absence of contrast-enhancing agents and irradiation. Hence, the method is suitable for future clinical and interventional studies and for characterization of defecation physiology.