Gollifer, Ruaridh M;
(2020)
Small bowel motility quantitation using MRI and its relationship to gastrointestinal symptoms.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
The small bowel is difficult to analyse due to its deep anatomical location and the large variation seen in individuals, in regard to both anatomy and function including motility. Dynamic MRI allows small bowel motility to be captured and visually assessed by radiologists, but there is often large inter-observer variation and a lack of complicated motility patterns being investigated. This thesis aims to explore the link between abnormal motility and gastrointestinal (GI) symptoms in Crohn’s disease (CD) and irritable bowel syndrome (IBS) using MRI. Firstly, a scan duration of 15 seconds and a temporal resolution of 1 image per second were shown to be sufficient for robust small bowel MRI motility measurements. Next, a validation study confirmed an association between aberrant motility and CD patient symptoms, particularly diarrhoeal stools (rho = -0.29). The strongest association was in patients with higher symptom severity (rho = -0.633). Building on this work, more complex motility metrics were developed and compared to subjective radiological scoring. Spatial and temporal variation were found to be associated with CD patient symptoms and were also particularly difficult to visually assess. The motility metrics were applied in clinical IBS data to explore differences in IBS subgroups. Significantly reduced temporal variation of motility (P < 0.001) and area of motile bowel (P < 0.001) was found in IBS-C (constipation-predominant) compared to IBS-M (mixed constipation and diarrhoea). Finally, texture analysis (TA) terminal ileum (TI) to colon ratios were found to be higher for TA contrast (P = 0.005) and lower for TA energy (P = 0.03) in IBS-C compared to healthy controls (HCs). Ascending colon diameter was shown to be significantly larger in IBS-C than HCs (P = 0.005).
Type: | Thesis (Doctoral) |
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Qualification: | Ph.D |
Title: | Small bowel motility quantitation using MRI and its relationship to gastrointestinal symptoms |
Event: | UCL (University College London) |
Open access status: | An open access version is available from UCL Discovery |
Language: | English |
Additional information: | Copyright © The Author 2020. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
UCL classification: | UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng |
URI: | https://discovery.ucl.ac.uk/id/eprint/10092143 |
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