Dark Lumen MR Colonography Based on Fecal Tagging For Detection of Colorectal Masses: Accuracy And Patient Acceptance

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Journal Title, Volume, Page: 
Abdom Imaging. 2005 Sep-Oct;30(5):576-83. Epub 2005 Mar 4
Year of Publication: 
2005
Authors: 
S. C. Goehde
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
E. Descher
Private practice for gastroenterology, I Hagen 26, Essen, 45127, Germany
A. Boekstegers
Private practice for gastroenterology, I Hagen 26, Essen, 45127, Germany
T. Lauenstein
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
C. Kühle
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
S. G. Ruehm
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
W. Ajaj
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Preferred Abstract (Original): 

BACKGROUND: Magnetic resonance colonography (MRC) with fecal tagging has recently been investigated in clinical studies for the detection of polyps. We assessed fecal tagging MRC in a field trial.
METHODS: Forty-two patients in a private gastroenterologic practice underwent MRC with barium-based fecal tagging (150 mL of 100% barium at each of 6 main meals before MRC) and conventional colonoscopy. Diagnostic accuracy of MRC and patient acceptance were assessed and compared with the respective results of conventional colonoscopy.
RESULTS: Eighteen percent of all MRC examinations showed a remaining high stool signal in the colon that impeded a reliable inclusion or exclusion of polyps. On a lesion-by-lesion basis, sensitivities for polyp detection were 100% for polyps larger than 2 cm (n = 1), 40% for polyps between 10 and 19 mm, 16.7% for polyps between 6 and 9 mm, and 9.1% for polyps smaller than 6 mm. The main reason for the low acceptance of MRC was the barium preparation, which was rated worse than the bowel cleaning procedure with conventional colonoscopy. CONCLUSION: MRC with fecal tagging must be further optimized. The large amount of barium resulted in poor patient acceptance, and barium according to this protocol did not provide sufficient stool darkening. Other strategies, such as increasing the hydration of stool, must be developed. 

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