Validation of New Cine Magnetic Resonance Imaging Parameters For The Differential Diagnosis of Chronic Idiopathic Intestinal Pseudo-Obstruction

Chronic idiopathic pseudo-obstruction (CIPO) is a severe and refractory intestinal motility disorder whose diagnosis currently relies on subjective imaging assessments. Cine magnetic resonance imaging (MRI) may potentially improve the quantitative analysis of gastrointestinal motility; however, suitable CIPO detection parameters should be determined.Cine MRI was performed in seven patients with CIPO and 11 healthy controls. The logarithm of the Mahalanobis distance (x 1 ) and luminal distance variation per time (x 2 ) were used as the original parameters to determine CIPO diagnostic thresholds. Furthermore, the correlation between cine MRI findings and CIPO severity was investigated.Threshold values of α=1.10 and β=0.15 for x1 and x2, respectively, produced a CIPO diagnosis sensitivity of 1.00 (7/7) and specificity of 0.82 (9/11). The resulting error was 0.11 (2/18). The two parameters were correlated (Pearson’s correlation coefficient: -0.52). The intestinal tracts of patients with severe CIPO requiring home parenteral nutrition belonged to the category defined by x 1 ≥1.10 and x 2 ≤0.15.Cine MRI is effective for the quantitative evaluation of small intestinal motility and CIPO diagnosis when using the abovementioned parameters and can be useful for treatment decision-making. However, these parameters have a wide distribution in healthy volunteers; this may complicate the detection of other disorders.