Zusammenfassung
Die Magnetresonanztomographie (MRT) stellt eine vielseitige bildgebende Methode in der Medizin dar, für welche ein Spektrum neuer diagnostischer Optionen entwickelt wurde. Neben der in der klinischen Praxis etablierten Darstellung von Organstrukturen, wird die MRT zunehmend zur Bildgebung humaner Organfunktionen wie zum Beispiel des Herzen und des zentralen Nervensystems herangezogen. Der Einsatz zur funktionellen Bildgebung des Verdauungstrakts ist neuartig und erfolgt an wenigen Zentren im Bereich der Grundlagen- und klinischen Forschung. Die hochauflösende kontrastreiche schnelle Bildgebung, die fehlende Belastung durch ionisierende Strahlung und die Untersucherunabhängigkeit in der Bildakquisition und Analyse machen die MRT zu einer idealen Methode der Funktionsdiagnostik des Verdauungstrakts.
In dieser Übersicht werden gegenwärtige Anwendungen der MRT in der gastroenterolgischen Funktionsdiagnostik vorgestellt und mit herkömmlichen diagnostischen Methoden verglichen.
Abstract
Magnetic resonance imaging (MRI) is a versatile medical imaging tool for which several new applications have been developed. Beside its broad clinical use for the detection of anatomical structures and pathologies MRI has been successfully applied for the non-invasive imaging of human organ functions, including the brain and the cardiovascular system. The use of MRI for the assessment and analysis of gastrointestinal (GI) function is a new approach that is currently performed in only a few research sites. Several characteristics make MRI an ideal technique for the direct assessment of GI physiology: MRI acquires high resolution images with excellent soft tissue contrast, it does not expose subjects to ionizing radiation, is non-invasive, and the acquisition and analysis of the images can be independently verified. In this article we summarize recent developments of MRI techniques in GI research. We will also discuss the advantages and limitations of MRI for this purpose in relation to established medical imaging tools and investigations.
Literatur
Schwizer W, Fox M, Steingotter A (2003) Non-invasive investigation of gastrointestinal functions with magnetic resonance imaging: towards an „ideal“ investigation of gastrointestinal function. Gut 52 [Suppl 4]: iv34–39
Hasler WL (1995) The physiology of gastric motility and gastric emptying. In: Yamada T (ed) Textbook of gastroenterology. Lippinicott, Philadelphia, pp 181–206
Spiegel TA, Fried H, Hubert CD, Peikin SR, Siegel JA, Zeiger LS (2000) Effects of posture on gastric emptying and satiety ratings after a nutritive liquid and solid meal. Am J Physiol Regul Integr Comp Physiol 279: R684–694
Schwizer W, Maecke H, Fried M (1992) Measurement of gastric emptying by magnetic resonance imaging in humans. Gastroenterology 103: 369–376
Parkman HP, Hasler WL, Fisher RS (2004) American Gastroenterological Association technical review on the diagnosis and treatment of gastroparesis. Gastroenterology 127: 1592–1622
Schwizer W, Fraser R, Maecke H, Siebold K, Funck R, Fried M (1994) Gd-DOTA as a gastrointestinal contrast agent for gastric emptying measurements with MRI. Magn Reson Med 31: 388–393
Feinle C, Kunz P, Boesiger P, Fried M, Schwizer W (1999) Scintigraphic validation of a magnetic resonance imaging method to study gastric emptying of a solid meal in humans. Gut 44: 106–111
Kunz P, Feinle C, Schwizer W, Fried M, Boesiger P (1999) Assessment of gastric motor function during the emptying of solid and liquid meals in humans by MRI. J Magn Reson Imaging 9: 75–80
Azpiroz F, Malagelada JR (1986) Vagally mediated gastric relaxation induced by intestinal nutrients in the dog. Am J Physiol 251: G727–735
Thumshirn M, Camilleri M, Saslow SB, Williams DE, Burton DD, Hanson RB (1999) Gastric accommodation in non-ulcer dyspepsia and the roles of Helicobacter pylori infection and vagal function. Gut 44: 55–64
Tefera S, Gilja OH, Hatlebakk JG, Berstad A (2001) Gastric accommodation studied by ultrasonography in patients with reflux esophagitis. Dig Dis Sci 46: 618–625
Tack J, Piessevaux H, Coulie B, Caenepeel P, Janssens J (1998) Role of impaired gastric accommodation to a meal in functional dyspepsia. Gastroenterology 115: 1346–1352
De Schepper HU, Cremonini F, Chitkara D, Camilleri M (2004) Assessment of gastric accommodation: overview and evaluation of current methods. Neurogastroenterol Motil 16: 275–285
Schwizer W, Steingotter A, Fox M, Zur T, Thumshirn M, Bosiger P, Fried M (2002) Non-invasive measurement of gastric accommodation in humans. Gut 51 [Suppl 1]: i59–62
Goetze O, Steingoetter A, Kwiatek MA et al. (2005) The Effect of Macronutrients on Gastric Accommodation and Dyspeptic Symptoms—a Magnetic Resonance Imaging Study. Gastroenterology 128: A 1764
Marciani L, Gowland PA, Spiller RC, Manoj P, Moore RJ, Young P, Fillery-Travis AJ (2001) Effect of meal viscosity and nutrients on satiety, intragastric dilution, and emptying assessed by MRI. Am J Physiol Gastrointest Liver Physiol 280: G1227–1233
Marciani L, Wickham M, Hills BP et al. (2004) Intragastric oil-in-water emulsion fat fraction measured using inversion recovery echo-planar magnetic resonance imaging. J Food Sci 69: E290–E296
Kunz P, Feinle-Bisset C, Faas H, Boesiger P, Fried M, Steingoetter A, Schwizer W (2005) Effect of ingestion order of the fat component of a solid meal on intragastric fat distribution and gastric emptying assessed by MRI. J Magn Reson Imaging 21: 383–390
Steingoetter A, Kunz P, Weishaupt D et al. (2003) Analysis of the meal-dependent intragastric performance of a gastric-retentive tablet assessed by magnetic resonance imaging. Aliment Pharmacol Ther 18: 713–720
Steingoetter A, Weishaupt D, Kunz P et al. (2003) Magnetic resonance imaging for the in vivo evaluation of gastric-retentive tablets. Pharm Res 20: 2001–2007
Treier R, Steingoetter A, Fried M, Schwizer W, Boesiger P (2005) Fast T1 mapping for the assessment of intragastric distribution, dilution and mixing. Proc ISMRM, 13th Scientific Meeting and Exhibition
Hausken T, Odegaard S, Matre K, Berstad A (1992) Antroduodenal motility and movements of luminal contents studied by duplex sonography. Gastroenterology 102: 1583–1590
Indireshkumar K, Brasseur JG, Faas H et al. (2000) Relative contributions of „pressure pump“ and „peristaltic pump“ to gastric emptying. Am J Physiol Gastrointest Liver Physiol 278: G604–616
Froehlich JM, Patak MA, von Weymarn C, Juli CF, Zollikofer CL, Wentz KU (2005) Small bowel motility assessment with magnetic resonance imaging. J Magn Reson Imaging 21: 370–375
Bali MA, Sztantics A, Metens T, Arvanitakis M, Delhaye M, Deviere J, Matos C (2005) Quantification of pancreatic exocrine function with secretin-enhanced magnetic resonance cholangiopancreatography: normal values and short-term effects of pancreatic duct drainage procedures in chronic pancreatitis. Initial results. Eur Radiol 15: 2110–2120
Bertschinger KM, Hetzer FH, Roos JE, Treiber K, Marincek B, Hilfiker PR (2002) Dynamic MR imaging of the pelvic floor performed with patient sitting in an open-magnet unit versus with patient supine in a closed-magnet unit. Radiology 223: 501–508
Interessenkonflikt:
Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Götze, O., Steingötter, A., Schwizer, W. et al. Funktionelle Magnetresonanzbildgebung des Verdauungstrakts. Internist 47, 28–38 (2006). https://doi.org/10.1007/s00108-005-1527-1
Issue Date:
DOI: https://doi.org/10.1007/s00108-005-1527-1
Schlüsselwörter
- Magnetresonanztomographie
- Funktionelle Bildgebung
- Gastrointestinale Motilität
- Magensekretion
- Magenakkomodation