Magnetic resonance imaging based colonography for diagnosis and assessment of diverticulosis and diverticulitis.
OBJECTIVE
MRI-based colonography is a new minimally invasive imaging modality to assess the colon and abdomen. This new method which is applied mainly for polyp screening could be an integrative approach for colonic diverticulitis assessment. This study evaluated the feasibility of MRI-based colonography to assess diverticulosis or diverticulitis.


METHODS
Fourteen consecutive patients with clinically suspected diverticulitis were examined by MRI colonography on a 1.5-T scanner. All patients underwent abdominal CT as gold standard. N-Butyl-scopalamin was given intravenously to reduce bowel peristalsis. After rectal administration of a T1-positive enema T1- and T2-weighted acquisitions with additional intravenous contrast were obtained. A 3D FLASH sequence was acquired for virtual colonography. The results were compared with CT and biological parameters such as white blood cell count and C-reactive protein.


RESULTS
Of 56 bowel segments (sigmoid colon, descending colon, transverse colon, ascending colon) in all 14 patients 54 were assessed to have good to fair image quality. Having CT as standard of reference, all sigmoid diverticula were diagnosed based on MRI. Inflammation as judged by CT was identically assessed on MRI. 3D models of the colon revealed further diverticula in the remaining colon; additionally, the 3D models gave a comprehensive image for surgical planning.


CONCLUSIONS
In our preliminary study MRI colonography revealed the same diagnosis as CT in all patients without ionizing radiation. Additionally, 3D-rendered models and virtual colonoscopy can be performed. This comprehensive 3D models could replace presurgical planning barium enema with concurrent assessment of the residual colon.
Schreyer
Andreas G
AG
Department of Radiology, University Hospital Regensburg, Regensburg, Germany. andreas.schreyer@klinik.uni-regensburg.de
Fürst
Alois
A
Agha
Ayman
A
Kikinis
Ron
R
Scheibl
Karl
K
Schölmerich
Jürgen
J
Feuerbach
Stefan
S
Herfarth
Hans
H
Seitz
Johannes
J
D000328:Adult; D000368:Aged; D023881:Colonography, Computed Tomographic / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage; D004239:Diverticulitis, Colonic / Q000473:pathology*; D004240:Diverticulum / Q000473:pathology*; D004733:Enema; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity
D003287:Contrast Media