In vivo observation of a stomach road or ‘Magenstrasse’ for gastric emptying using MRI imaging in healthy humans

Abstract

Summary: The presence of a ‘magenstrasse’, a central ‘stomach road’ for flow and mixing of foods and drinks in the stomach had been predicted from hydrodynamic modelling. Here a magnetic resonance imaging (MRI) tagging technique was used to gain novel insights on the intragastric motion of breakfast porridges in 17 healthy humans. They consumed two similar breakfast porridge meals on separate days and tagging images with two different delay times were acquired 15 and 45 minutes postprandially, generating 128 data sets. Motion of the gastric contents was assessed by coefficient of variation (CoV) analysis across timeframes. The data showed that postprandial movement occurred already at the first imaging point after feeding. The motion of the gastric contents occurred along the central axis of the stomach appearing as a central ‘magenstrasse’ reaching the stomach body/fundus region in 73% of cases. Only in 10% of cases the displacement and smearing of the tag lines was detected close to the stomach walls. Seven % of data sets showed antegrade (towards the antrum) motion whilst a much larger percentage of motion was observed to be only retrograde (43%) or mixed antegrade and retrograde (50%). In conclusion, the MRI tagging method allowed novel insights into the movement of stomach contents using real model porridge meals and confirmed the existence of a central ‘stomach road’ for intragastric flow and mixing of food.

Keywords

• MRI
• Tagging
• Gastric contents
• Motion
• Intragastric handling
• Breakfast