Pan-alimentary assessment of motility, luminal content, and structures: an MRI-based framework

Abstract

Background

Gastrointestinal symptoms originating from different segments overlap and complicate diagnosis and treatment. In this study, we aimed to develop and test a pan-alimentary framework for the evaluation of gastrointestinal (GI) motility and different static endpoints based on magnetic resonance imaging (MRI) without contrast agents or bowel preparation.

Methods

Twenty healthy volunteers (55.6 ± 10.9 years, BMI 30.8 ± 9.2 kg/m²) underwent baseline and post-meal MRI scans at multiple time points. From the scans, the following were obtained: Gastric segmental volumes and motility, emptying half time (T50), small bowel volume and motility, colonic segmental volumes, and fecal water content. Questionnaires to assess GI symptoms were collected between and after MRI scans.

Key results

We observed an increase in stomach and small bowel volume immediately after meal intake from baseline values (p<.001 for the stomach and p=.05 for the small bowel). The volume increase of the stomach primarily involved the fundus (p<.001) in the earliest phase of digestion with a T50 of 92.1 ± 35.3 min. The intake of the meal immediately elicited a motility increase in the small bowel (p<.001). No differences in colonic fecal water content between baseline and 105 min were observed.

Conclusion & Inferences

We developed a framework for a pan-alimentary assessment of GI endpoints and observed how different dynamic and static physiological endpoints responded to meal intake. All endpoints aligned with the current literature for individual gut segments, showing that a comprehensive model may unravel complex and incoherent gastrointestinal symptoms in patients.

Keywords:

• Magnetic resonance imaging
• abdomen
• gastrointestinal motility
• gastrointestinal diseases
• nausea

Acknowledgments

We thank Kenneth Krogh Jensen (Aalborg University Hospital) for the assistance in the data collection and the Radiology Research Unit for providing MRI scanner facilities.

Author contributions

Davide Bertoli, Esben Bolvig Mark, Jens Brøndum Frøkjær, Donghua Liao, Birgitte Brock, Filip Krag Knop, Klaus Krogh, and Asbjørn Mohr Drewes designed the research; Davide Bertoli, Esben Bolvig Mark, and Donghua Liao were involved in data collection; Asbjørn Mohr Drewes, Davide Bertoli, Christina Brock, and Jens Brøndum Frøkjær directed the data interpretation; Davide Bertoli drafted and wrote the manuscript; All the authors revised the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study is supported by a Novo Nordisk Foundation [Grant No. #0052045].