MR Colonography Without Bowel Purgation For The Assessment of Inflammatory Bowel Diseases: Diagnostic Accuracy And Patient Acceptance

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Journal Title, Volume, Page: 
Inflamm Bowel Dis Volume 13, Number 8, August 2007
Year of Publication: 
2007
Authors: 
Jost Langhorst
Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Germany
Christiane A. Kuhle
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany
Waleed Ajaj
Department of Radiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Michael Nufer
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany
Jorg Barkhausen
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany
Andreas Michalsen
Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Germany
Gustav J. Dobos
Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Germany
Thomas C. Lauenstein
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany
Preferred Abstract (Original): 

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.

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