Skip to main content
SpringerLink
Log in

Clinical importance of cine-MRI assessment of small bowel motility in patients with chronic intestinal pseudo-obstruction: a retrospective study of 33 patients

  • Original Article—Alimentary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

Although chronic intestinal pseudo-obstruction (CIPO) is a rare and extremely severe functional digestive disorder, its clinical course and severity show various patterns. We assessed small bowel peristalsis in CIPO patients using cine-MRI (video-motion MRI) and their clinical characteristics to evaluate the clinical importance of performing cine-MRI in patients with this intractable disease.

Methods

The medical records of 131 patients referred to our institution with a suspected diagnosis of CIPO between 2010 and 2015 were retrospectively evaluated. Thirty-three patients (22 female/11 male; age range 16–79 years) who met the criteria for CIPO and underwent cine-MRI were enrolled. Mean luminal diameter (MLD), contraction ratio (CR), and contraction cycle (CC) were determined and compared with these parameters in healthy volunteers. Clinical outcomes in patients with CIPO were also evaluated.

Results

The median follow-up time was 25.2 months (range, 1–65 months). Of the 33 patients with CIPO, 23 (70 %) showed apparently disturbed small intestinal peristalsis, whereas 10 (30 %) did not. The percentage of patients requiring intravenous alimentation was significantly higher (p = 0.03), and the mean serum albumin level was significantly lower (p = 0.04), in patients with than without impaired small intestinal peristalsis. Although both cine-MRI and CT findings in the latter ten cases were within the normal range, MLD and CR differed significantly from healthy volunteers.

Conclusions

Cine-MRI is useful in predicting severe clinical features in patients with CIPO, and in detecting slightly impaired small contractility that cannot be detected on CT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Cogliandro RF, De Giorgio R, Barbara G, et al. Chronic intestinal pseudo-obstruction. Best Pract Res Clin Gastroenterol. 2007;21:657–69.

    Article  PubMed  Google Scholar 

  2. Stanghellini V, Cogliandro RF, De Giorgio R, et al. Natural history of intestinal failure induced by chronic idiopathic intestinal pseudo-obstruction. Transplant Proc. 2010;42:15–8.

    Article  CAS  PubMed  Google Scholar 

  3. Stanghellini V, Cogliandro RF, De Giorgio R, et al. Chronic intestinal pseudo-obstruction: manifestations, natural history and management. Neurogastroenterol Motil. 2007;19:440–52.

    Article  CAS  PubMed  Google Scholar 

  4. Antonucci A, Fronzoni L, Cogliandro L, et al. Chronic intestinal pseudo-obstruction. World J Gastroenterol. 2008;14:2953–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Mann SD, Debinski HS, Kamm MA. Clinical characteristics of chronic idiopathic intestinal pseudo-obstruction in adults. Gut. 1997;41:675–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Sutton DH, Harrell SP, Wo JM. Diagnosis and management of adult patients with chronic intestinal pseudoobstruction. Nutr Clin Pract. 2006;21:16–22.

    Article  PubMed  Google Scholar 

  7. Iida H, Ohkubo H, Inamori M, et al. Epidemiology and clinical experience of chronic intestinal pseudo-obstruction in Japan: a nationwide epidemiologic survey. J Epidemiol. 2013;23:288–94.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Amiot A, Joly F, Alves A, et al. Long-term outcome of chronic pseudo-obstruction adult patients requiring home parenteral nutrition. Am J Gastroenterol. 2009;104:1262–70.

    Article  PubMed  Google Scholar 

  9. Stanghellini V, Cogliandro RF, De Giorgio R, et al. Natural history of chronic idiopathic intestinal pseudo-obstruction in adults: a single center study. Clin Gastroenterol Hepatol. 2005;3:449–58.

    Article  PubMed  Google Scholar 

  10. De Giorgio R, Sarnelli S, Corinaldesi R, et al. Advances in our understanding of the pathology of chronic intestinal pseudo-obstruction. Gut. 2004;53:1549–52.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Lindberg G, Tornblom H, Iwarzon M, et al. Full-thickness biopsy findings in chronic intestinal pseudo-obstruction and enteric dysmotility. Gut. 2009;58:1084–90.

    Article  CAS  PubMed  Google Scholar 

  12. Ohkubo H, Iida H, Takahashi H, et al. An epidemiologic survey of chronic intestinal pseudo-obstruction and evaluation of the newly proposed diagnostic criteria. Digestion. 2012;86:12–9.

    Article  PubMed  Google Scholar 

  13. Lauro A, De Giorgio R, Pinna AD. Advancement in the clinical management of intestinal pseudo-obstruction. Expert Rev Gastroenterol Hepatol. 2015;9:197–208.

    Article  CAS  PubMed  Google Scholar 

  14. Miazga A, Osinski M, Cichy W, et al. Current views on the etiopathogenesis, clinical manifestation, diagnostics, treatment and correlation with other nosological entities of SIBO. Adv Med Sci. 2015;60:118–24.

    Article  PubMed  Google Scholar 

  15. Scolapio JS, Fleming CR, Kelly DG, et al. Survival of home parental nutrition-treated patients: 20 years of experience at the Mayo Clinic. Mayo Clin Proc. 1999;74:217–22.

    Article  CAS  PubMed  Google Scholar 

  16. Amiot A, Joly F, Cazals-Hatem D, et al. Prognostic yield of esophageal manometry in chronic intestinal pseudo-obstruction: a retrospective cohort of 116 adult patients. Neurogastroenterol Motil. 2012;24:1008–e542.

  17. Stanghellini V, Cogliandro R, Cogliandro L, et al. Clinical use of manometry for the diagnosis of intestinal motor abnormalities. Dig Liver Dis. 2000;32:532–41.

    Article  CAS  PubMed  Google Scholar 

  18. Bassotti G, Bologna S, Ottaviani L, et al. Intestinal manometry: who needs it? Gastroenterol Hepatol Bed Bench. 2015;8:246–52.

    PubMed  PubMed Central  Google Scholar 

  19. Rao SS, Camilleri M, Hasler WL, et al. Evaluation of gastrointestinal transit in clinical practice: position paper of the American and European Neurogastroenterology and Motility Societies. Neurogastroenterol Motil. 2011;23:8–23.

    Article  CAS  PubMed  Google Scholar 

  20. Takahara T, Kwee TC, Sadahiro S, et al. Low b-value diffusion-weighted imaging for diagnosing strangulated small bowel obstruction: a feasibility study. J Magn Reson Imaging. 2011;34:1117–24.

    Article  PubMed  Google Scholar 

  21. Ohkubo H, Kessoku T, Fuyuki A, et al. Assessment of small bowel motility in patients with chronic intestinal pseudo-obstruction using cine-MRI. Am J Gastroenterol. 2013;108:1130–9.

    Article  PubMed  Google Scholar 

  22. Wakamiya M, Furukawa A, Kanasaki S, et al. Assessment of small bowel motility function with cine-MRI using balanced steady-state free precession sequence. J Magn Reson Imaging. 2011;33:1235–40.

    Article  PubMed  Google Scholar 

  23. Masaki T, Sugihara K, Nakajima A, et al. Nationwide survey on adult type chronic intestinal pseudo-obstruction in surgical institutions in Japan. Surg Today. 2012;42:264–71.

    Article  PubMed  Google Scholar 

  24. Lindberg G, Iwarzon M, Tornblom H. Clinical features and long-term survival in chronic intestinal pseudo-obstruction and enteric dysmotility. Scand J Gastroenterol. 2009;44:692–9.

    Article  PubMed  Google Scholar 

  25. Amiot A, Cazals-Hatem D, Joly F, et al. The role of immunohistochemistry in idiopathic chronic intestinal pseudoobstruction (CIPO): a case-control study. Am J Surg Pathol. 2009;33:749–58.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Hiroshi Takahashi for his technical assistance and Kyoko Koike for her clerical assistance. This study was supported in part by grants for the Rare/Intractable Disease Project from the Japan Agency for Medical Research and Development (15545459).

Author information

Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Akiko Fuyuki, Hidenori Ohkubo, Takuma Higurashi, Yumi Inoh & Atsushi Nakajima

  2. Department of Medical Education, Yokohama City University School of Medicine, Yokohama, Japan

    Hiroshi Iida & Masahiko Inamori

Authors
  1. Akiko Fuyuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hidenori Ohkubo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takuma Higurashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroshi Iida
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yumi Inoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Masahiko Inamori
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Atsushi Nakajima
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Atsushi Nakajima.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to disclose.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fuyuki, A., Ohkubo, H., Higurashi, T. et al. Clinical importance of cine-MRI assessment of small bowel motility in patients with chronic intestinal pseudo-obstruction: a retrospective study of 33 patients. J Gastroenterol 52, 577–584 (2017). https://doi.org/10.1007/s00535-016-1251-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00535-016-1251-8

Keywords

Search

Navigation