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Eur J Cardiothorac Surg 2006;30:663-668
© 2006 Elsevier Science NL

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

^a Dipartimento di Scienze Radiologiche, Università di Roma ‘La Sapienza’, Viale Regina Elena 324, 00161-Rome, Italy
^b Divisione di Chirurgia Toracica, Università di Roma ‘La Sapienza’, Rome, Italy

Received 8 May 2006; received in revised form 4 July 2006; accepted 10 July 2006.

^_* Corresponding author. Tel.: +39 03358443792; fax: +39 03358443792. (Email: valeria.panebianco{at}uniroma1.it).

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°; 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 0.5 M, 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.

Key Words: Esophagus • Esophagectomy • Narrow gastric tube • Magnetic resonance • Functionality