Authors: goetze, o.¹; treier, r.²; fox, m.; steingoetter, a.; fried, m.; boesiger, p.; schwizer, w.

Source: Neurogastroenterology and Motility, Volume 21, Number 7, July 2009 , pp. 725-e42(-724)

Publisher: Wiley-Blackwell

Abstract:

 

Conventional measurement of gastric secretion is invasive and cannot assess the intra-gastric distribution of gastric contents or the effects of secretion on gastric function. This study assessed the effect of gastric secretion on gastric volume responses and emptying (GE) using a validated fast T₁ mapping magnetic resonance imaging (MRI) technique. Twelve healthy participants were studied in the fasted state and after 200 kcal Gadolinium-DOTA labelled glucose meal during intravenous infusion of pentagastrin or placebo in double-blind, randomized order. Total gastric volume (TGV) and gastric content volume (GCV) was assessed by MRI volume scans and secretion by fast T₁ mapping. Data was described by the κ-coefficient (volume change after meal ingestion), by GE half time (T₅₀) and maximal GE rate (GER_max) derived all from a GE model. Pentagastrin increased GCV and TGV compared to placebo [κ(GCV):1.6 ± 0.1 vs 0.6 ± 0.1; κ(TGV): 1.6 ± 0.1 vs 0.7 ± 0.1; P < 0.001]. T₁ maps revealed a secretion layer above the meal, the volume of which was associated with κ (R² = 83%, P < 0.001). TGV and GCV change were similar in both conditions (κ; P = ns). T₅₀ was higher for pentagastrin than for placebo (84 ± 7 vs 56 ± 4min, P < 0.001); however, GER_max was similar (5.9 ± 0.6 vs 4.9 ± 0.4 mL min⁻¹, P = ns). This study shows volume and distribution of gastric secretion can be quantified in-vivo by non-invasive MRI T₁ mapping. Increased GCV drove TGV accommodation without evidence of a direct effect of pentagastrin or excess acid on gastric function. Secretion increases GCV thus prolongs GE as assessed by T₅₀; however, GE rate is unchanged.

Keywords: gastric emptying; gastric physiology; gastric secretion; magnetic resonance imaging; T1 mapping

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2982.2009.01293.x

Affiliations: 1: Division of Gastroenterology, University Hospital Zurich, Zurich, Switzerland 2: Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland

Publication date: 2009-07-01

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