Small bowel strictures in Crohn's disease: a quantitative investigation of intestinal motility using MR enterography. Issue 12 (12th September 2013)

• Record Type: Journal Article
• Authors: Menys, A.; Helbren, E.; Makanyanga, J.; Emmanuel, A.; Forbes, A.; Windsor, A.; Punwani, S.; Halligan, S.; Atkinson, D.; Taylor, S. A.
• Is Part Of: Neurogastroenterology & motility. Volume 25:Issue 12(2013:Dec.)
• Page Start: 967
• Page End: e775
• Publication Date: 2013-09-12
• Subjects: Gastrointestinal system -- Motility -- Periodicals; Gastrointestinal system -- Innervation -- Periodicals; 616.33
• DOI: 10.1111/nmo.12229
• Languages: English
• ISSNs: 1350-1925

Abstract

<abstract abstract-type="main" id="nmo12229-abs-0001"> <title>Abstract</title> <sec id="nmo12229-sec-0001" sec-type="section"> <title>Background</title> <p>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).</p> </sec> <sec id="nmo12229-sec-0002" sec-type="section"> <title>Methods</title> <p>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 <sc>anova</sc> and diameter correlated with motility score. In 21 subjects with follow‐up MRE, ROIs were duplicated and percentage diameter and motility change across the two time points correlated.</p> </sec> <sec id="nmo12229-sec-0003" sec-type="section"> <title>Key Results</title> <p>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.</p> </sec> <sec id="nmo12229-sec-0004" sec-type="section"> <title>Conclusions & Inferences</title> <p>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.</p> </sec> </abstract>