Real-time MRI for dynamic assessment of gastroesophageal reflux disease: Comparison to pH-metry and impedance

2020-04 | journal article; research paper. A publication of Göttingen

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​Real-time MRI for dynamic assessment of gastroesophageal reflux disease: Comparison to pH-metry and impedance​
Hosseini, A. S. A. ; Uhlig, J.; Streit, U.; Gliem, N. ; Wedi, E. ; Ellenrieder, V.   & Ghadimi, M. B.  et al.​ (2020) 
European Journal of Radiology125 art. 108856​.​ DOI: 

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Hosseini, Ali Seif Amir ; Uhlig, Johannes; Streit, Ulrike; Gliem, Nina ; Wedi, Edris ; Ellenrieder, Volker ; Ghadimi, Michael B. ; Ahmed, Saheeb ; Uecker, Martin ; Frahm, Jens ; Lotz, Joachim ; Biggemann, Lorenz
Purpose To evaluate the diagnostic potential of real-time MRI for dynamic assessment of gastroesophageal reflux in patients with GERD (gastroesophageal reflux disease)-like symptoms compared to pH-metry and impedance. Methods Patients who underwent real-time MRI and pH-metry between 2015–2018 were included in this retrospective study. Real-time MRI at 3 T was achieved by undersampled radial FLASH acquisitions with iterative image reconstruction by NLINV. Real-time MRI visualized transit of pineapple juice through the gastroesophageal junction and during Valsalva maneuver. MRI results were compared to 24 h pH-metry to assess acidic reflux (following Lyon Consensus guidelines) and to impedance to assess non-acidic reflux. A standard 2 × 2 table was chosen to calculate diagnostic performance. Results 91/93 eligible patients fulfilled inclusion criteria (male n = 49; female n = 42; median age 55 y). All MRI studies were successfully completed without adverse events at a mean examination time of 15 min. On real-time MRI, reflux was evident in 60 patients (66 %). pH-metry revealed reflux in 41 patients (45 %), and impedance in 54 patients (59 %). Compared to pH-metry and impedance, real-time MRI sensitivity was 0.78 (95 % CI: 0.66-0.87), specificity 0.67 (95 % CI: 0.45-0.84) and PPV 0.87 (95 % CI: 0.75-0.94). Conclusion Real-time MRI is an imaging method for assessment of gastroesophageal reflux in patients with GERD-like symptoms. Considering its high positive predictive value, real-time MRI can accurately identify patients in which further invasive testing with pH-metry and impedance might be considered.
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European Journal of Radiology 



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