Evaluation of the anti-peristaltic effect of glucagon and hyoscine on the small bowel: comparison of intravenous and intramuscular drug administration

Gutzeit, Andreas; Binkert, Christoph A.; Koh, Dow‐Mu; Hergan, Klaus; Weymarn, Constantin von; Graf, Nicole; Patak, Michael A.; Roos, Justus E.; Horstmann, Marcus; Kos, Sebastian; Hungerbühler, Simone; Froehlich, Johannes M.

doi:10.1007/s00330-011-2366-1

Cited by 82 publications

(60 citation statements)

References 14 publications

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“…In one European study, 92% of academic radiologists surveyed used a spasmolytic agent, most commonly hyoscine butylbromide (Buscopan Ò , Boehringer-Ingelheim, Ingelheim, Germany) which is an agent approved outside of the USA [12]. In the USA, most centers use glucagon (GlucaGen Ò , Novo Nordisk, DK-2880 Bagsvaerd) [26,32]. However, it is important to note that cine BSSFP sequences should be performed before spasmolytic agents are administered.…”

Section: Discussionmentioning

confidence: 99%

“…First established with fluoroscopy, small bowel peristalsis can be evaluated with MRE using a cine balanced steady-state free precession series (cine BSSFP) [20]. In patients with known Crohn's disease, inflamed small bowel segments can have motility changes which usually manifest as decreased or absent peristalsis compared to normal small bowel segments [21][22][23][24][25][26][27][28][29][30][31][32].…”

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

et al. 2014

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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

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Section: Discussionmentioning

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

et al. 2014

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“…Butylscopolamine relaxes enteric smooth muscle owing to its antagonism of muscarinic receptors. Gutzeit et al (17) used segmental quantification of motility to show at least a 50% decrease in segmental bowel motility after administration of 40 mg in six volunteers. In our study, 20 mg produced a strong and predictable antikinetic effect, reducing motility by approximately 56%.…”

Section: Gastrointestinal Imaging: Assessment Of Global Small Bowel Mmentioning

confidence: 99%

Global Small Bowel Motility: Assessment with Dynamic MR Imaging

Menys¹,

Taylor²,

Emmanuel³

et al. 2013

Radiology

101

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“…The appropriate antispasmotics are hyoscine butylbromide, (Buscopan, Boehringer Ingel- heim Pharma GmbH & Co KG, Germany) and glucagon, with studies showing glucagon to induce a longer period of spasmolysis [26]. Intravenous administration results in a faster and more reliable onset of effect [27]. One of the relevant sequences is an axial or coronal T2-weighted sequence (half-fourier single-shot turbo spin echo, HASTE with Siemens; single-shot fast spin echo, SSFSE with General Electric or ultra-fast spin echo, UFSE with Philips), which offers a good overview of the wall thickness of the intestinal segments as well as of any existing edema.…”

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confidence: 99%

Magnetic Resonance Imaging of the Bowel: Today and Tomorrow

Kinner

Hahnemann

Forsting

et al. 2015

Fortschr Röntgenstr

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Magnetic resonance imaging of the small bowel has been feasible for more than 15 years. This review is meant to give an overview of typical techniques, sequences and indications. Furthermore, newly evaluated promising techniques are presented, which have an impact on the advance of MR imaging of the small and large bowel. Key Points: ??T2-weighted sequences both with and without fat saturation and T1-weighted fat saturated sequences prior to and following intravenous injection of a gadolinium-based contrast medium contitute the basics for bowel MR imaging. ??Newer MR applications, such as diffusion-weighted imaging or contrast-enhaced dynamic sequences supply addtional information; they should thus be integrated in a regular sequence protocol f?r bowel MRI. ??Additional new modalities like motility imaging and PET/MRI have to be evaluated in future studies. Citation Format: ??Kinner S, Hahnemann ML, Forsting M et?al. Magnetic Resonance Imaging of the Bowel: Today and Tomorrow. Fortschr R?ntgenstr 2015; 187: 160???167

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Evaluation of the anti-peristaltic effect of glucagon and hyoscine on the small bowel: comparison of intravenous and intramuscular drug administration

Cited by 82 publications

References 14 publications

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

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

Global Small Bowel Motility: Assessment with Dynamic MR Imaging

Magnetic Resonance Imaging of the Bowel: Today and Tomorrow

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