| Physiology of the small bowel: A new approach using MRI and proposal for a new metric of function. | |
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MedLine Citation:
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PMID: 21382671 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: The mechanics of small bowel motility are extremely complex. Routine clinical access to small bowel has been restricted to radiological enteric contrast studies which have not contributed significantly to the understanding of small bowel physiology. Small bowel mechanics are understood within a framework of individual visible or measurable elements such as peristaltic wave formation, intra-luminal pressure gradients and transit times. There are no global measures of small bowel function that can be readily obtained in vivo in humans. Magnetic resonance imaging (MRI) is playing an increasingly important role in radiological diagnosis of small bowel disease and dynamic MRI offers the possibility of capturing small bowel movement in three-dimensional cinematic datasets. The metrics that are used to describe small bowel mechanics, typically anatomical measures in isolated segments, are not suited to analysing these large dynamic datasets. The proposal in this paper is to leave behind all previously described anatomical metrics and to describe anew the mechanics of small bowel movement in mathematical terms derived from changes in pixel intensity within dynamic MRI datasets so that global small bowel activity might be summarised in a single novel metric. HYPOTHESIS: The hypothesis of this paper is that global small bowel activity can be quantified by a new dynamic MR based metric. EVALUATION: A proposed strategy for evaluation includes a progression through feasibility, optimisation, reliability and validation studies. Thereafter normal volunteers would be required in order to define normal ranges for the new metric. These ranges would describe small bowel activity during fasting or after ingestion of fluids and standard meals. Mathematical modelling of the data could follow a two stage approach. The first stage could be to study segmentation or extraction techniques by which the small bowel activity could be isolated from MRI signal generated by the rest of the abdomen. The second stage would be to apply a number of data mining techniques that would identify significant features within the datasets. CONCLUSION: If this approach proves to be a useful model for studying small bowel physiology in humans, it would afford significant new avenues of research and treatment particularly in areas such as enteric drug delivery, the ageing gut, and nutrition. |
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Authors:
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Andoni P Toms; Aser Farghal; Bahman Kasmai; Anthony Bagnall; Paul N Malcolm |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-5 |
Journal Detail:
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Title: Medical hypotheses Volume: - ISSN: 1532-2777 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-8 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7505668 Medline TA: Med Hypotheses Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Elsevier Ltd. All rights reserved. |
Affiliation:
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Norwich Radiology Academy, Cotman Centre, Colney Lane, Norwich, Norfolk NR4 7UB, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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