An-Najah Staff

Background: The purpose of this pilot study was to assess the diagnostic accuracy of MR colonography (MRC) without bowel cleansing regarding its ability to quantify inflammatory bowel disease (IBD). In addition, patient acceptance was compared with conventional colonoscopy (CC).
Methods: In all, 29 patients with IBD (17 ulcerative colitis; 12 Crohn’s disease) were included. While CC was performed after bowel cleansing as the gold standard, MRC was based on a fecal tagging technique and performed 48–72 hours prior to CC. The presence of inflammation in each of 7 ileocolonic segments was rated for every procedure. Patients evaluated both modalities and dedicated aspects of the examination according to a 10-point-scale (1  good, 10  poor acceptance). Furthermore, preferences for future examinations were investigated.
Results: Inflammatory segments were found by means of CC in 23 and by MRC in 14 patients. Overall sensitivity and specificity of MRC in a segment-based detection were 32% and 88%, respectively. Concerning severely inflamed segments, sensitivity increased to 53% for MRC. Overall acceptance of CC was significantly higher compared to MRC (mean value (mv) for MRT  6.0; CC  4.1; P  0.003). For MRC, the placement of the rectal tube (mv  7.3), and for CC bowel purgation (mv  6.5), were rated as the most unpleasant. A total of 67% of patients voted for CC as the favorable tool for future examinations.
Conclusions: The presented data indicate that ‘fecal tagging MRC’ is not suitable for an adequate quantification of inflammatory diseases of the large bowel. Furthermore, overall acceptance of endoscopic colonoscopy was superior to MRC.

Purpose: To assess whether the detection of colorectal lesions can be improved using high spatial resolution VIBE imaging.
Materials and Methods: 48 patients underwent same-day dark lumen MR colonography (MRC) and conventional colonoscopy (CC) as the standard for the detection of colorectal masses. MRC was performed using contrast-enhanced standard and high spatial resolution T1-weighted 3D VIBE sequences. The findings and the image quality of the standard and high spatial resolution VIBE sequences were compared qualitatively and quantitatively. The findings of both sequences regarding colorectal lesions were compared to those of a subsequently performed colonoscopy.
Results: The high spatial resolution VIBE sequence significantly improved the quantitative image quality (CNR 54.0 vs. 36.8). However, high spatial resolution VIBE imaging did not detect more colorectal lesions than the standard VIBE sequence. In addition, none of the sequences employed was able to detect lesions with a diameter of less than 5mm (CC 40 lesions). However, 13 colorectal lesions with a diameter of greater than 5mm were detected by both sequences (CC 15).
Conclusion: High spatial resolution VIBE imaging did not improve the detection of colorectal masses and MRC fails to detect colorectal lesions with a diameter of less than 5 mm.