Measurement of oro-caecal transit time by magnetic resonance imaging

Edoardo Savarino, Vincenzo Savarino, Mark Fox, Giovanni Di Leo, Manuele Furnari, Elisa Marabotto, Lorenzo Gemignani, Luca Bruzzone, Alessandro Moscatelli, Chiara De Cassan, Francesco Sardanelli, Luca Maria Sconfienza

Research output: Contribution to journalArticlepeer-review


Objectives: To assess prospectively the agreement of orocaecal transit time (OCTT) measurements by lactulose hydrogen breath test (LHBT) and magnetic resonance imaging (MRI) in healthy subjects. Methods: Volunteers underwent abdominal 1.5-T MRI using axial and coronal single-shot fast-spin-echo T2-weighted sequences, having fasted and after lactulose ingestion (10 g/125 mL). Imaging and H2 excretion gas-chromatography were performed concurrently every 15 min up to 180 min. MR images were analyzed using semiautomatic segmentation to calculate small bowel gas volume (SBGV) and visually to detect bolus arrival in the caecum. Agreement between MRI- and LHBT-OCTT was assessed. Results: Twenty-eight subjects (17 men/11 women; mean age ± standard deviation 30 ± 8 years) were evaluated. Two H2 non-producers on LHBT were excluded. OCTT measured by MRI and LHBT was concordant in 18/26 (69 %) subjects (excellent agreement, k = 0.924). Median SBGV was 49.0 mL (interquartile interval 44.1 – 51.6 mL). In 8/26 (31 %) subjects, MRI showed that the lactulose bolus was in the terminal ileum and not the caecum when H2E increased on LHBT. Median OCTT measured by MRI was significantly longer than OCTT measured by LHBT [135 min (120 – 150 min) vs. 127.5 min (105 – 150 min); p = 0.008]. Above baseline levels, correlation between [H2] and SBGV was significant (r = 0.964; p <0.001). Conclusions: MRI provides valid measurements of OCTT and gas production in the small bowel. Key Points: • MRI is a valid technique to measure OCTT. • Excellent agreement between MRI and LHBT was found. • Measuring gas production using MRI may provide evidence of small bowel fermentation.

Original languageEnglish
Pages (from-to)1579-1587
Number of pages9
JournalEuropean Radiology
Issue number6
Publication statusPublished - Jun 1 2015


  • Irritable bowel syndrome
  • Lactulose hydrogen breath test
  • Magnetic resonance imaging
  • Orocaecal transit time
  • Small bowel

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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