Magnetic resonance-fluoroscopy as long-term follow-up examination in patients with narrow gastric tube reconstruction after radical esophagectomy.

OBJECTIVE To evaluate the functionality and morphology of neo-esophagus in subjects who underwent narrow gastric tube (NGT) reconstruction after total esophagectomy using magnetic resonance (MR)-fluoroscopy with Turbo-FLASH sequences acquired during positive oral contrast agent administration. METHODS AND MATERIALS Ten patients, who underwent NGT reconstruction after total esophagectomy between 2002 and 2004, were studied using a 1.5 T magnet (Magnetom Avanto: Siemens, Erlangen, Germany, featuring total imaging matrix-TIM technology), equipped with surface phased-array and integrated spine coils. Imaging protocol included TRUFI and Turbo-FLASH sequences (TR=600 ms; TE=1.3 ms; Flip Angle 8 degrees ; Thickness 20 mm; FoV 350; Matrix 128 x 256; N. acquisition 120; TA=50 s) acquired on sagittal and axial planes to achieve motility evaluation during oral administration of positive contrast agent (yoghurt+Gd-DTPA 0.5M, 1:100 boluses). RESULTS Good quality images were obtained in all patients, with adequate lumen contrast and a frame rate of 2.5 frames per second (fps). Three patients had completely re-established motility of NGT; six patients had mild to moderate alterations including raised transit time, reflux and contrast agent stasis; one patient had severe alterations with grossly dilated NGT, severe reflux and stasis. CONCLUSIONS MR-fluoroscopy approach represents a promising radiation-free modality in the evaluation of functionality and morphology of NGT. Further investigation in the evaluation of post-surgery patients is necessary.