Reflux diseases, such as gastro-oesophageal reflux disease (GERD/GORD) and laryngopharyngeal reflux (LPR), have a substantial impact on individuals’ lives. Precise diagnosis is crucial for effective management.

A recent study has shed light on the potential of real-time MRI (magnetic resonance imaging) in the diagnosis of reflux diseases. While not yet a widely established practice, this research also offers a glimpse into the possibilities that lie ahead.

In this blog post, we’ll explore the findings of this study as well as the significance of accurate reflux diagnosis.

What is MRI?

Magnetic resonance imaging, or MRI, is a powerful medical imaging technique that allows healthcare providers to peer inside the human body with exceptional detail and precision. Unlike traditional X-rays or CT scans, MRI does not use ionising radiation. Instead, it relies on the interaction between radio waves and the body’s natural magnetic properties.

Patients undergoing MRI typically lie still inside a large, tube-like machine while the procedure takes place.

Real-time MRI is an advanced imaging modality that offers the unique combination of exceptional image quality as well as high temporal resolution. Temporal resolution in MRI refers to the ability to capture images with very short time intervals between each frame, as fast as 20 milliseconds per frame.

What the new MRI study addressed

Researchers have explored the possibilities offered by real-time MRI.

This study, conducted between 2015 and 2018, involved patients with symptoms of GERD for at least six months. The research was carried out at the University Medical Centre Goettingen, Germany, and people with specific medical conditions, like pacemakers or incompatible implants, were excluded.

The study used pineapple juice as an oral contrast agent. Instead of traditional contrast agents that some people might be allergic to, the researchers opted for a natural alternative with pineapple juice. Pineapple is rich in manganese, which makes it ideal for enhancing MRI images without any risk of allergies.

Before real-time imaging, preliminary images were taken to plan the main scans. These sequences help set the stage for the detailed imaging.

A key part of the study involved tracking the movement of the liquid (similar to swallowing) through the oesophagus and esophagogastric junction. This helped in understanding how reflux occurs in real-time. A breathing technique was also used to see how it affects the junction as well as the potential for reflux.

Each frame was taken every 40 milliseconds, providing a real-time view at 25 frames per second. The entire real-time MRI session lasted for 28 seconds.

What did they look for?

Two radiologists looked for signs of reflux (the flow of stomach contents into the oesophagus) and hiatal hernias (a condition where the stomach bulges into the chest through an opening in the diaphragm). Reflux was identified when they saw visible fluid or signal changes in the oesophagus during the breathing technique.

What they concluded?

The study suggests a potential role for real-time MRI as a complementary diagnostic tool alongside established tests like pH-metry and impedance.

Gastro-oesophageal reflux was detected in 63.6 per cent of the patients. Notably, spontaneous reflux occurred in 26.5 per cent of patients without the need for specific manoeuvres after swallowing pineapple juice.

Among the patients who underwent combined 24-hour pH-metry and impedance (a test to measure acid reflux), 73.6 per cent showed pathological results. Interestingly, real-time MRI detected reflux in 77.6 per cent of these patients. Conversely, patients with normal 24-hour pH-metry and impedance measurements often did not present reflux on real-time MRI.

Peptest as an early diagnostic test

Accurate reflux diagnosis remains crucial, and tools like Peptest play a valuable role in helping individuals regain control of their wellbeing and quality of life.

Peptest, a saliva reflux diagnostic test, offers a non-invasive and painless alternative. It doesn’t require complex equipment or uncomfortable procedures. All it takes is a simple saliva sample, making it an ideal choice for individuals seeking answers to their reflux-related concerns.

Peptest offers a convenient as well as effective starting point for individuals dealing with reflux symptoms, providing valuable insights and guiding them toward the right path for diagnosis and treatment.

The Visualization of Deglutition and Gastroesophageal Reflux Using Real-Time MRI: A Standardized Approach to Image Acquisition and Assessment study is published in Scientific Reports journal.


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