The measurement of gastric motor function and transit in man by echo planar magnetic resonance imaging

Echo-planar imaging (EPI) can be used to produce snapshot images of the human stomach and antro-pyloro-duodenal segment in real time as an alternative technique to intubation and exposure to ionizing radiation. The method has been further developed to monitor simultaneous gastric motility and gastric emptying of liquid and solid meals. The model has been utilized to study the effects of pharmacological agents on gastric function. Eight normal subjects were imaged in a 0.5-T superconducting magnet for up to 6 h following ingestion of 800 ml tap water, followed by 500 ml porridge test meal + 500 ml tap water. A rapid multislice technique was adopted to image adjacent transverse slices (10 mm thick) through the gastric region. In addition, three subjects were orally dosed with 20 mg of the prokinetic agent Cisapride. Gastric volumes for each slice were calculated and summed to produce a measure of total gastric volume and gastric emptying. Contractile activity at the level of the antro-pyloric segment was detected using sequential 128 ms images at 3 s intervals. Alternate measurements of gastric volume and motility were made for the duration of the study. Gastric emptying T_1/2's (times to empty 50% of the gastric contents) of 12.9 min for water and 116 min for porridge were in agreement with results obtained by the traditional techniques of gamma scintigraphy and impedance imaging. The frequency of gastric contractions increased from 2.4 contractions per minute (cpm) to 3.2 cpm following water and from 2.9 to 3.2 cpm following porridge. The prokinetic effect of enhanced coordination of antroduodenal contractions was also observed. These studies have demonstrated that EPI can be used to detect and image gastroduodenal function in man, totally noninvasively, and can be used to study the effects of drugs acting on the gastrointestinal tract.