Simultaneous assessment of colon motility in children with functional constipation by cine-MRI and colonic manometry: a feasibility study

M H Vriesman,S Kuizenga-Wessel,J Stoker,A Menys,B Adler,C Di Lorenzo,C S De Jonge,M A Benninga,A J Nederveen

doi:10.1186/s41747-021-00205-5

Abstract

BackgroundColonic manometry is the current reference standard for assessing colonic neuromuscular function in children with intractable functional constipation (FC). Recently, cine magnetic resonance imaging (cine-MRI) has been proposed as a non-invasive alternative. We compared colonic motility patterns on cine-MRI with those obtained by manometry in children, by stimulating high-amplitude propagating contractions (HAPCs) with bisacodyl under manometric control while simultaneously acquiring cine-MRI.MethodsAfter Institutional Review Board approval, adolescents with FC scheduled to undergo colonic manometry were included. A water-perfused 8-lumen catheter was used for colonic manometry recordings. After an intraluminal bisacodyl infusion, cine-MRI sequences of the descending colon were acquired for about 30 min simultaneously with colonic manometry. Manometry recordings were analysed for HAPCs. MRI images were processed with spatiotemporal motility MRI techniques. The anonymised motility results of both techniques were visually compared for the identification of HAPCs in the descending colon.ResultsData regarding six patients (three males) were analysed (median age 14 years, range 12–17). After bisacodyl infusion, three patients showed a total of eleven HAPCs with colonic manometry. Corresponding cine-MRI recorded high colonic activity during two of these HAPCs, minimal activity during seven HAPCs, while two HAPCs were not recorded. In two of three patients with absent HAPCs on manometry, colonic activity was recorded with cine-MRI.ConclusionsSimultaneous acquisition of colonic cine-MRI and manometry in children with FC is feasible. Their motility results did not completely overlap in the identification of HAPCs. Research is needed to unravel the role of cine-MRI in this setting.

Highlights

Colonic manometry is the current reference standard for assessing colonic neuromuscular function in children with intractable functional constipation (FC)
Colonic manometry has been shown to be a valuable diagnostic test in the differentiation between normal colonic motility patterns, which are present in functional constipation, versus colonic neuromuscular disorders [5]
Interpretation of colonic manometry recordings involves the identification of high-amplitude propagating contractions (HAPCs) after a meal or chemically induced by stimulants such as bisacodyl

Summary

Introduction

Colonic manometry is the current reference standard for assessing colonic neuromuscular function in children with intractable functional constipation (FC). We compared colonic motility patterns on cine-MRI with those obtained by manometry in children, by stimulating high-amplitude propagating contractions (HAPCs) with bisacodyl under manometric control while simultaneously acquiring cine-MRI. Colonic manometry has been shown to be a valuable diagnostic test in the differentiation between normal colonic motility patterns, which are present in functional constipation, versus colonic neuromuscular disorders [5]. Accurate assessment of colonic motility can be essential in the work-up of intractable functional constipation and may serve as a useful guide for medical and surgical strategies [5]. Interpretation of colonic manometry recordings involves the identification of high-amplitude propagating contractions (HAPCs) after a meal or chemically induced by stimulants such as bisacodyl. The presence of HAPCs is one of the indicators of normal colonic motility [5]

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Results

Conclusion