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01.02.2012 | Gastrointestinal

Is there a role for dynamic swallowing MRI in the assessment of gastroesophageal reflux disease and oesophageal motility disorders?

verfasst von: Christiane Kulinna-Cosentini, W. Schima, J. Lenglinger, M. Riegler, C. Kölblinger, A. Ba-Ssalamah, G. Bischof, M. Weber, P. Kleinhansl, E. P. Cosentini

Erschienen in: European Radiology | Ausgabe 2/2012

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Abstract

Objectives

To evaluate the diagnostic value of dynamic MRI swallowing in patients with symptoms of Gastroesophageal Reflux Disease (GERD).

Methods

Thirty-seven patients (17 m/20f) with typical signs of GERD underwent MR swallowing in the supine position at 1.5 T with a phased-array body coil. Using dynamic, gradient echo sequences (B-FFE) in the coronal, sagittal and axial planes, the bolus passages of buttermilk spiked with gadolinium chelate were tracked. MRI, pH-metry and manometry were performed within 31 days and results were compared.

Results

MRI results were concordant with pH-metry in 82% (23/28) of patients diagnosed with abnormal oesophageal acid exposure by pH-metry. Five patients demonstrated typical symptoms of GERD and had positive findings with pH monitoring, but false negative results with MRI. In four of six patients (67%), there was a correct diagnosis of oesophageal motility disorder, according to manometric criteria, on dynamic MRI. The overall accuracy of MRI diagnoses was 79% (27/34). A statistically significant difference was found between the size of hiatal hernia, grade of reflux in MRI, and abnormal acid exposure on pH-monitoring.

Conclusions

MR fluoroscopy may be a promising radiation-free tool in assessing the functionality and morphology of the GE junction.

Key Points

• Swallowing MRI can assess anatomy and function of the gastroesophageal-junction

• Swallowing MRI can help identifying reflux and motility disorders

• Definition of the size of hiatal hernias is possible in all three planes in MR.

• Short duration of swallowing MRI enables its application in routine clinical practice

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Titel: Is there a role for dynamic swallowing MRI in the assessment of gastroesophageal reflux disease and oesophageal motility disorders?
verfasst von: Christiane Kulinna-Cosentini
W. Schima
J. Lenglinger
M. Riegler
C. Kölblinger
A. Ba-Ssalamah
G. Bischof
M. Weber
P. Kleinhansl
E. P. Cosentini
Publikationsdatum: 01.02.2012
Verlag: Springer-Verlag
Erschienen in: European Radiology / Ausgabe 2/2012
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-011-2258-4

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Is there a role for dynamic swallowing MRI in the assessment of gastroesophageal reflux disease and oesophageal motility disorders?