Erratum to: Identifying decreased peristalsis of abnormal small bowel segments in Crohn’s disease using cine MR enterography: the frozen bowel sign

Abstract

Purpose: The purpose of this study was to evaluate whether affected bowel in Crohn's disease patients can be identified by observing decreased peristalsis (frozen bowel sign) using cine balanced steady-state free precession (cine BSSFP) images. Materials and methods: 5 radiologists independently reviewed cine BSSFP sequences from randomized MR Enterography (MRE) exams for 30 normal and 30 Crohn's disease patients, graded overall small bowel peristalsis from slowest to fastest, and graded peristalsis for the most abnormal small bowel segment. Sensitivity and specificity of the frozen bowel sign for diagnosing Crohn's disease were calculated. T tests of the peristalsis difference between abnormal segments and overall small bowel were conducted. Results: For 5 readers, the sensitivity and specificity of cine BSSFP of the frozen bowel sign for diagnosing Crohn's disease ranged from 70% to 100% and 87% to 100%, respectively. There were significant differences in peristalsis between abnormal small bowel segments and the overall small bowel for Crohn's patients, but not in the overall small bowel between normal-MRE patients and Crohn's disease patients. Conclusion: Abnormal Crohn's small bowel segments have significantly decreased peristalsis compared to normal small bowel, which can be identified using cine BSSFP sequences as the frozen bowel sign.Key words: MR enterography-Small bowelPeristalsis-Motility-Cine MRI-Crohn's disease Erratum to: Abdom Imaging DOI 10.1007/s00261-014-0258-yThe original publication did not include the images pertaining to the supplementary video files. This has been corrected in this article.Using MR enterography (MRE) to diagnose inflamed small bowel segments in patients with Crohn's disease requires a multiparametric approach, evaluating imaging features from several different pulse sequences. The most commonly used imaging features are well established in the literature for both CT scan [1][2][3][4] and MRI [5][6][7][8][9][10][11][12][13][14][15]. These include bowel wall thickening, bowel wall edema, perienteric edema and fluid, and mucosal, transmural, and possibly serosal hyperenhancement after intravenous contrast or gadolinium administration. With MRE, these Electronic supplementary material: The online version of this article

Detecting the effects of a standardized meal challenge on small bowel motility with MRI in prepared and unprepared bowel

“…Reassuringly, these results are comparable to the motility measured in a previous study with twenty, mannitol prepared, healthy subjects (mean index 0.34; range, [0.28‐0.39]), supporting the validity of our results . This motility‐driving effect of mannitol is interesting because it can be used to our advantage in clinical testing bringing into relief regions of hypo‐motile intestine potentially affected by inflammation or fibrosis . Similarly, tethered regions of bowel, due to adhesions or fistulae, might also be highlighted by the general increase in motility driven by the effects of mannitol.…”

“…MRI is non‐invasive, safe and widely available and, coupled with advances in post‐processing technologies, enables rapid and repeatable quantification . Encouragingly, the first steps toward clinical implementation have been taken with dynamic motility imaging now being routine in various centers and with several prospective clinical studies being published …”

“…[3][4][5][6][7][8][9][10][11] Encouragingly, the first steps toward clinical implementation have been taken with dynamic motility imaging now being routine in various centers and with several prospective clinical studies being published. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The gastrointestinal tract is complex, undergoing fasted and fed contractile cycles that take place over hours, such as the migrating motor complex. 20 It is not practical to perform prolonged MRI imaging of the intestine in a clinical setting.…”

Evaluation of gastrointestinal motility with MRI: Advances, challenges and opportunities

“…Several studies show that small bowel motility quantified with dynamic MRI can be used as a biomarker of inflammatory activity in Crohn's disease and to differentiate healthy from diseased bowel . The motility in the terminal ileum was lower in Crohn's patients in comparison to healthy subjects .…”

“…The simplest method to interpret dynamic MR images is evaluation by visual assessment of propagation direction and incidence of phasic contractions at specified sites in the GI tract (Figure 1 A-B). 29 This can be performed by a radiologist who observes all consecutive images of a bowel segment and grades the contractile activity on a 5-point scale 30,31 or by using a classification system. 32,33 Visual assessment is a relatively simple technique that can easily be used in daily clinical practice by trained radiologists when validated.…”