Assessment of Small Bowel Motility Using Cine-magnetic Resonance Imaging in Patients Suspected With Chronic Intestinal Pseudo-obstruction.

BACKGROUND/AIMS: Chronic intestinal pseudo-obstruction (CIPO), characterized by dilated small or large intestine on CT, has a high postoperative recurrence rate. In contrast, focal hypoganglionosis with adult-onset megacolon (FHAM) generally shows a good postoperative prognosis. This study aims to evaluate the utility of cine-MRI in differentiating between these 2 diseases by assessing small bowel (SB) motility and its correlation with clinical outcomes.

METHODS

The clinical features and outcomes of 41 prospectively enrolled patients suspected of having CIPO who underwent cine-MRI were reviewed. Multi-slice cine-MRI was conducted.

RESULTS

Of 41 patients suspected of having CIPO, 17 showed SB dilatation on CT, while 24 did not. According to cine-MRI, 3 exhibited decreased SB motility, while 38 showed no motility reduction. Among the 17 patients with dilated SB on CT, only 3 demonstrated decreased SB motility on cine-MRI. By contrast, all patients with nondilated SB on CT exhibited normal SB motility on cine-MRI. Patients with decreased SB motility showed a higher rate of postoperative disease recurrence (P = 0.011) and continuation of medication after surgery (P = 0.020) than in those with normal SB motility.

CONCLUSIONS

Cine-MRI is useful in assessing SB motility that cannot be detected on CT. Its usefulness extends to aiding surgical decision-making, particularly in differentiating between FHAM and CIPO.