Abstract
MRI is increasingly used to objectively assess gastrointestinal motility. However, motility metrics often do not offer insights into the nature of contractile action. This study introduces a systematic method of making spatio-temporal measurements of contractions, based on changes in bowel lumen diameter. Two heterogeneous cohorts of subjects were selected displaying gastric (n=15) and colonic motility (n=20) on which to test the spatio-temporal motility MRI (STMM) technique. STMM involved delineating the bowel lumen along with inner and outer bowel wall along a section of the gastrointestinal tract. A series of diameter measurements were made automatically across the central axis of the lumen. Measurements were automatically propagated through the time series using a previously validated algorithm. Contractions were quantitatively summarized with two methods measuring (a) normalized contraction plot (NCP) and (b) combined velocity distance (CVD) both of which can be visualized as spatio-temporal motility maps. Both metrics were correlated against subjective visual scoring systems. Good correlation was seen between reader scores and both motility metrics (NCP, R=0.85, P<0.001, CVD, R=0.93, R<0.001) in the gastric data. Good correlation was also seen between the reader scores and the two metrics in the colonic data (NCP, R=0.82, P<0.001, CVD, R=0.78, R<0.001). Spatio-temporal motility MRI analysis of the stomach and colon correlates well with reader scores in a range of datasets and provides both a quantitative and qualitative means of assessing contractile activity in the gastrointestinal tract.
Highlights
Gastrointestinal motility is complex and highly variable both within and between individuals in both health and disease
One of the key challenges faced by the research and clinical communities is the relative paucity of investigative tools[1]
Aberrant coordination of contractile activity is often a key feature of dysmotility recorded by high resolution manometry[14]
Summary
Gastrointestinal motility is complex and highly variable both within and between individuals in both health and disease. One of the key challenges faced by the research and clinical communities is the relative paucity of investigative tools[1] In both the upper and lower GI tract Manometry is still considered the gold standard for detailed analysis of motility, based on the assessment of intraluminal pressure change, but is invasive and burdensome from a time and cost perspective. Despite a number of technical advancements enabling reproducible quantification of the data, motility analysis remains crude, essentially classification into hyper and hypo motile contractile states[8,9,10] Such analysis may be sufficient in some disease conditions, notably Crohn’s disease, where hypomotility is a biomarker of inflammatory burden[2,11,12]. This study introduces a systematic method of making spatiotemporal measurements of contractions, based on changes in bowel lumen diameter
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