Visualization of deglutition and gastroesophageal reflux using real-time MRI: a standardized approach to image acquisition and assessment

Lorenz Biggemann, Johannes Uhlig, Ulrike Streit, Omar Al-Bourini, Edris Wedi, Ahmad Amanzada, Volker Ellenrieder, Felix Rühlmann, Michael Ghadimi, Jens Frahm, Martin Uecker, Ali Seif Amir Hosseini

Research output: Contribution to journalArticlepeer-review

Abstract

This study aims to develop a standardized algorithm for gastroesophageal image acquisition and diagnostic assessment using real-time MRI. Patients with GERD symptoms undergoing real-time MRI of the esophagus and esophagogastric junction between 2015 and 2018 were included. A 10 ml bolus of pineapple juice served as an oral contrast agent. Patients performed Valsalva maneuver to provoke reflux and hiatal hernia. Systematic MRI assessment included visual presence of achalasia, fundoplication failure in patients with previous surgical fundoplication, gastroesophageal reflux, and hiatal hernia. A total of 184 patients (n = 92 female [50%], mean age 52.7 ± 15.8 years) completed MRI studies without adverse events at a mean examination time of 15 min. Gastroesophageal reflux was evident in n = 117 (63.6%), hiatal hernia in n = 95 (52.5%), and achalasia in 4 patients (2.2%). Hiatal hernia was observed more frequently in patients with reflux at rest (n = 67 vs. n = 6, p < 0.01) and during Valsalva maneuver (n = 87 vs. n = 8, p < 0.01). Real-time MRI visualized a morphologic correlate for recurring GERD symptoms in 20/22 patients (90%) after fundoplication procedure. In a large-scale single-center cohort of patients with GERD symptoms undergoing real-time MRI, visual correlates for clinical symptoms were evident in most cases. The proposed assessment algorithm could aid in wider-spread utilization of real-time MRI and provides a comprehensive approach to this novel imaging modality.

Original languageEnglish
Article number22854
JournalScientific Reports
Volume13
Issue number1
DOIs
Publication statusPublished - 21 Dec 2023

Keywords

  • Humans
  • Female
  • Adult
  • Middle Aged
  • Aged
  • Hernia, Hiatal/diagnostic imaging
  • Deglutition
  • Esophageal Achalasia/etiology
  • Gastroesophageal Reflux/etiology
  • Magnetic Resonance Imaging/methods
  • Laparoscopy/methods
  • Treatment Outcome

ASJC Scopus subject areas

  • General

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