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Small bowel strictures in Crohn's disease: a quantitative investigation of intestinal motility using MR enterography
Author(s) -
Menys A.,
Helbren E.,
Makanyanga J.,
Emmanuel A.,
Forbes A.,
Windsor A.,
Punwani S.,
Halligan S.,
Atkinson D.,
Taylor S. A.
Publication year - 2013
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.12229
Subject(s) - motility , gastroenterology , medicine , magnetic resonance imaging , retrospective cohort study , correlation , radiology , biology , mathematics , genetics , geometry
Abstract Background Intestinal stricturing and aberrant small bowel motility are common complications in patients with Crohn's disease ( CD ) leading to significant morbidity. A retrospective study was performed quantifying small bowel motility within and upstream of strictures in CD patients using magnetic resonance enterography ( MRE ). Methods A total of 91 subjects with stricturing CD (mean age 36 range 18–88) and undergoing MRE with dynamic motility imaging were identified. Of this cohort, 84 subjects were scanned at 1.5 T field strength with the remainder at 3 T. Linear regions of interest ( ROI ) were placed at the stricture, immediately upstream of the stricture, and in a proximal normal segment of bowel. Maximum bowel calibre (mm) and motility (Arbitrary units) at each ROI were calculated using previously validated software. Diameters and motility were compared using repeat measures anova and diameter correlated with motility score. In 21 subjects with follow‐up MRE , ROI s were duplicated and percentage diameter and motility change across the two time points correlated. Key Results Mean diameter within the normal, prestricture and strictured bowel was 20, 30, and 15 mm (p < 0.001) with motility score 0.43, 0.28, and 0.15 AU, respectively (p < 0.001). There was a negative correlation between prestricture bowel diameter and motility (Pearson's R = −0.47, p < 0.001). For patients with follow‐up MRE , there was a negative correlation between percentage change in prestricture diameter and motility, Spearman's Rho −0.6 p = 0.007. Conclusions & Inferences Quantified small bowel motility during MRE differs significantly between normal, prestricture, and strictured bowel. As prestricture bowel dilates, motility decreases, although this appears reversible in some.