Bowel & Female Pelvis
Monday 3 May 2010
Room A8 16:30-18:30 Moderators: Georg M. Bongartz and Thomas Lauenstein

16:30   Introduction: Bowel
Thomas Lauenstein
16:42 158.

Feasibility of Small Bowel Flow Rate Measurement with MRI – A Volunteer Study
Johannes M. Froehlich1,2, Michael A. Patak1, Constantin von Weymarn2, Nicole Graf3, Aleksis Doert2, Edwin Willemse2, Christoph A. Binkert2, Andreas Gutzeit2

1Institute of Diagnostic, Interventional and Pediatric Radiology, University Hospital, Bern, Switzerland; 2MR Research, Kantonsspital Winterthur, Winterthur, Switzerland; 3Clinical Trials Center, University Hospital, Zürich, Switzerland

The aim of our prospective volunteer study was to develop and validate a new MR technique based on phase-contrast pulse sequences to measure intraluminal flux of the gastrointestinal content in single segments of the small bowel. Time-resolved small bowel flux was successfully measured in single distended small bowel loops within all 10 volunteers. A mean flow-rate of 0.188 ml/sec (range 0.027-0.516ml/sec) with a standard deviation of 0.144ml/sec resulted. Phase-contrast sequences together with low gadolinium concentrations allow measuring even low flow-rates within the small bowel highlightening its physiology as validated with a high degree of accuracy (R=0.999) in a phantom study.

16:54 159. 

Validation of Software Assisted Small Bowel Motility Analysis
Michael A. Patak1, Stephan Raible2, Zsolt Szuecs-Farkas1, Roger Cattin2, Hanspeter Bouquet3, Urs Bill3, Jonas Steinhauser1, Peter Vock1, Johannes M. Froehlich1

1Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital, University Hospital, Bern, BE, Switzerland; 2Virtual Perception Group, University of Applied Sciences, Bern, BE, Switzerland; 3Sohard AG, Bern, Switzerland

MR analysis of small bowel motility is a new technique to identify and localize functional pathologies. A newly developed software prototype permitting semi-automatic measurement was evaluated in comparison to measurement by hand. 52patients, overall 110evaluations were included. Overall 97/110(88.2%) of the motility curves were in agreement with each other with 86/110(78.2%) presenting a parallel shifting of the curves. No significant difference(p=0.65) was found for the peristaltic frequencies, while the amplitudes differed significantly(p=0.011). The newly developed software prototype for quantification of small bowel peristalsis proves as a valuable tool for fast, standardized and accurate measurement of small bowel motility.

17:06 160

Macromolecular Dynamic Contrast Enhanced (DCE) MRI Characterizes Hyperpermeability of the Intestinal Microvasculature in a Colitis Model
Katrien Vandoorne1, Tegest Aychek2, Steffen Jung2, Michal Neeman1
Biological Regulation, Weizmann Institute, Rehovot, Israel; 2Immunology, Weizmann Institute, Rehovot, Israel

In this work, we imaged and characterized blood vessels in the colon in an animal colitis model, where C57 black mice were exposed to DSS in the drinking water for 7 days, and developed a protocol for detection of alterations of the microvasculature in colitis. We showed with non-invasive macromolecular DCE-MRI, plasma protein leakage to the colon, highlighting the focal patches of colitis in post contrast 3D rendering. Macromolecular DCE-MRI demonstrated to be able to identify severe colitis and the loss of plasma proteins.

17:18 161.  

Assessment of Reflux-Induced Esophageal Compliance Using Concurrent Magnetic Resonance Imaging and High-Resolution Manometry
Jelena Curcic1, Andreas Steingoetter1,2, Reto Treier1, Elad Kaufman3,4, Zsofia Forras-Kaufman3, Mark Fox3,5, Werner Schwizer3, Michael Fried3, Peter Boesiger1
Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland; 2Institute of Radiology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany; 3Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland; 4Institute for Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; 5Nottingham Digestive Diseases Centre and Biomedical Research Unit, University Hospital, Nottingham, United Kingdom

The prevalence of the gastro-esophageal reflux disease (GERD) amounts to 10% to 20% worldwide and is higher in the western than in the eastern countries. However, the influence of aggressive gastric acid on the esophageal muscles is poorly described. Concurrent magnetic resonance imaging (MRI) and high-resolution manometry (HRM) were used to assess the esophageal compliance induced by reflux events in healthy volunteers and GERD patients. The results show significant esophageal distention difference but only small pressure difference between two groups. This indicates that esophageal distention may be a sensitive parameter for assessment of esophageal compliance even without invasive manometry measurement.

17:30   Introduction: Female Pelvis
Georg M. Bongartz
17:42 162

Evaluation of Magnetic Resonance Diffusion and Spectroscopy Measurements as Predictive Biomarkers in Stage 1 Cervical Cancer
Maria A. Schmidt1, Geoffrey S. Payne1, Veronica A. Morgan1, Sharon Giles1, Jane Bridges2, Thomas Ind2, Nandita deSouza1

1CRUK/ESPRC Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, MRI Unit , Sutton, England, United Kingdom; 2Gynaecological Oncology, Royal Marsden NHS Foundation Trust and Chelsea & Westminster Hospital, London, United Kingdom

This study applies functional MRI techniques (DWI and MRS) to cervical tumors with different histological characteristics (type, degree of differentiation and presence or absence of lymphovascular invasion) in order to investigate their potential as predictive biomarkers. There was a statistically significant difference between the ADC of well/moderately differentiated tumors compared with poorly differentiated tumors. There was no significant difference between the ADCs of the tumors when separated by other characteristics. There was no significant difference in tCho between any of the tumor categories investigated and no correlation between tumor ADC and tCho.

17:54 163

Oxygenation in Cervical Cancer and Normal Uterine Cervix Assessed Using BOLD MRI at 3 Tesla: Initial Experiences
Rami Robert Hallac1, Yao Ding1, Qing Yuan1, Roderick W. McColl1, Jayanthi Lea2, Robert D. Sims1, Paul T. Weatherall1, Ralph P. Mason1

1Radiology, UT Southwestern Medical Center at Dallas, Dallas, TX, United States; 2Ob-Gyn Oncology, UT Southwestern Medical Center at Dallas, Dallas, TX

BOLD MRI is sensitive to tumor vascular oxygenation and may provide an indication of tumor hypoxia. We have studied normal volunteers and women with locally advanced cervical cancer to evaluate the response to breathing oxygen. Tumors showed a BOLD signal intensity response between 2.5 and 20 % at 3 T. Normal cervical tissue and uterine lining also responded, but muscle tended to show no signal enhanced in T2* weighted signal. T2* maps showed ÄR2* = 4.23±3.2s-1 in normal cervix. Overall the procedure was well tolerated providing a non-invasive approach to investigating tumor oxygenation.

18:06 164.  

Diffusion Tensor Imaging at 7 Tesla as a Probe of Uterine Fibroid Morphology
Michael Jonathan Thrippleton1, Kirsty Irene Munro1, Mark E. Bastin2, Maurits A. Jansen2, Gavin D. Merrifield2, Scott I. K. Semple3, Anca Oniscu1, Andrew W. Horne1, Alistair R. Williams1, Graham McKillop4, Ian Marshall2, David E. Newby, 3,5, Hilary O. D. Critchley1
1Centre for Reproductive Biology, University of Edinburgh, Edinburgh, Lothian, United Kingdom; 2Department of Medical Physics, University of Edinburgh; 3Clinical Research Imaging Centre, University of Edinburgh; 4Department of Radiology, Royal Infirmary of Edinburgh; 5Centre for Cardiovascular Science, University of Edinburgh

We are developing MR biomarkers for assessing the mechanism and effectiveness of new medical treatments for uterine fibroids — benign growths of uterine muscle, present in up to 70% of women of reproductive age. In this abstract, we describe the results of development work aimed at probing the water diffusion properties of the ex-vivo fibroid uterus at 7 T; we measure the water diffusion parameters of fibroid tissue subtypes and compare diffusion eigenvector maps with macroscopic tissue appearance.

18:18 165

MR Imaging Evaluation of PCOS in Adolescents - not available
Matthew Austin1, Alice Park1, R. Jeffrey Chang1, Michele A. Brown1
1Radiology, UCSD Medical Center San Diego, CA, United States

This study compares MRI appearance of the ovary in adolescent girls with and without PCOS. Subjects were 32 girls between the ages of 12 and 19 years; 16 girls with clinical and biochemical evidence of PCOS and 16 girls without PCOS. Two radiologists independently recorded ovarian volume, follicle count per ovary, and follicle size.  Average follicle count per ovary and ovarian volume were higher in PCOS subjects compared to non-PCOS subjects.  MR imaging appearance of the ovary differs between adolescent girls with and without PCOS. MR imaging may help evaluate young patients in whom transvaginal ultrasound is contraindicated.



Back to Main Meeting

Back to Home