Dark Lumen Magnetic Resonance Enteroclysis in Combination With Mri Colonography for Whole Bowel Assessment in Patients With Crohnʼs Disease: First Clinical Experience
| Autor: | Markus Lenhart, Karl Scheibl, Hans H Herfarth, Antje Timmer, M. Völk, Jürgen Schölmerich, S. Feuerbach, G. Rogler, Stefan Gölder, Johannes Seitz, Andreas G. Schreyer |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Gadolinium DTPA Male medicine.medical_specialty Adolescent Colon Contrast Media Lumen (anatomy) Colonoscopy Sensitivity and Specificity Crohn Disease Intestine Small Image Processing Computer-Assisted medicine Medical imaging Humans Immunology and Allergy In patient Prospective Studies Grading (tumors) Aged Crohn's disease medicine.diagnostic_test business.industry Gastroenterology Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging digestive system diseases Stenosis Feasibility Studies Female Radiology business |
| Zdroj: | Inflammatory Bowel Diseases. 11:388-394 |
| ISSN: | 1078-0998 |
| DOI: | 10.1097/01.mib.0000164022.72729.06 |
| Popis: | Background: Magnetic resonance enteroclysis (MRE) is a recently introduced imaging technique that assesses the small bowel with similar sensitivity and specificity as the fluoroscopically performed conventional enteroclysis. Magnetic resonance imaging colonography (MRC) seems to be a promising technique for polyp assessment in the colon. In this feasibility study, we evaluated the combination of small bowel MRI with unprepared MRC as an integrative diagnostic approach of the whole bowel in patients with Crohn's disease. Methods: Thirty patients with known Crohn's disease were prospectively examined. No particular colonic preparation was applied. Applying the dark lumen technique in all patients, MRE and MRC were performed within 1 session using an integrative examination protocol. T2-weighted and contrast-enhanced T1-weighted sequences were acquired. Inflammation assessment (grades 0 to 2) of the colon was compared with conventional colonoscopy in 29 patient and with surgery in 1 patient. The entire colon was graded fair to good distended in all patients. In 11 of 210 evaluated colonic segments, feces hindered an adequate intraluminal bowel assessment. Twenty-three of 30 patients had complete colonoscopy as the gold standard. In 7 patients, complete colonoscopy could not be performed because of an inflamed stenosis. Results: Correct grading of colonic inflammation was performed with 55.1% sensitivity and 98.2% specificity in all segments. Considering only more extensive inflammation (grade 2), the sensitivity of MRC increased to 70.2% with a specificity of 99.2%. Conclusions: The combination of MRE and MRC could improve the diagnostic value of abdominal MRI evaluation in patients with Crohn's disease. However, MRC can not replace conventional colonoscopy in subtle inflammation assessment. |
| Databáze: | OpenAIRE |
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