Magnetic resonance colonography for the detection of inflammatory diseases of the large bowel: quantifying the inflammatory activity.
BACKGROUND
The purpose of this study was to assess the diagnostic accuracy of magnetic resonance colonography (MRC) for its ability to detect and quantify inflammatory bowel disease (IBD) affecting the colon. Endoscopically obtained histopathology specimens were used as the standard of reference.


METHODS
Fifteen normal subjects and 23 patients with suspected IBD of the large bowel underwent MRC. Three dimensional T1 weighted data sets were collected following rectal administration of water prior to and 75 seconds after intravenous administration of paramagnetic contrast (gadolinium-BOPTA). The presence of inflammatory changes in patients was documented based on bowel wall contrast enhancement, bowel wall thickness, presence of perifocal lymph nodes, and loss of haustral folds. All four criteria were quantified relative to data obtained from normal subjects and summarised in a single score. This MRC based score was compared with histopathological data based on conventional endoscopic findings.


RESULTS
MRC correctly identified 68 of 73 segments found to reveal IBD changes by histopathology. All severely inflamed segments were correctly identified as such and there were no false positive findings. Based on the proposed composite score, MRC detected and characterised clinically relevant IBD of the large bowel with sensitivity and specificity values of 87% and 100%, respectively, for all investigated colonic segments.


CONCLUSIONS
MRC may be considered a promising alternative to endoscopic biopsy in monitoring IBD activity or assessing therapeutic effectiveness.
Ajaj
W M
WM
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstr 55, Essen 45122, Germany. waleed.ajaj@uni-essen.de
Lauenstein
T C
TC
Pelster
G
G
Gerken
G
G
Ruehm
S G
SG
Debatin
J F
JF
Goehde
S C
SC
D000328:Adult; D003092:Colitis / Q000175:diagnosis* / Q000473:pathology; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000473:pathology; D003113:Colonoscopy; D003287:Contrast Media; D003424:Crohn Disease / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds; D012680:Sensitivity and Specificity
D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine