[MR-colonography in hospitalized patients: feasibility and sensitivity].
BACKGROUND
Besides conventional colonoscopy, CT and MR colonography offer alternate virtual imaging modalities of the colon. The sensitivity of CT colonography, which is associated with radiation exposure, has been published in prior, large studies. Regarding MR colonography, in particular dark lumen MR colonography with the rectal administration of a water enema as a contrast agent, only limited published data exist. The goal of this study was to compare MR colonography with conventional colonoscopy in the detection of colorectal polyps. In addition the feasibility and image quality in unselected hospitalised patients were assessed.


METHODS
Included were 103 hospitalised patients who had to undergo colonoscopy for various indications. Immediately prior to conventional colonoscopy, MR colonography with rectal water enema and additional intravenous administration of contrast material was performed. Detection rates for polyps and adenomas were documented with both imaging modalities. Image quality and completion rates (practicability) and other (incidental) findings were also recorded.


RESULTS
In 15 of 103 patients the MR examination could not be done or was only partially completed. The detection rate of MR colonography for polyps (adenomas) was 2% (4%) for polyps (adenomas) up to 5 mm in diameter, 38% (56%) for polyps (adenomas) 6-10 mm in diameter and 89% (89%) for polyps (adenomas) up to 11 mm in diameter. One flat carcinoma seen with conventional coloscopy was missed on MR colonography.


CONCLUSIONS
MR colonography offers the possibility of imaging the colon without exposure to radiation. Polyps and adenomas are detected, similar to the detection rate of CT colonography, with adequate sensitivity only if they are larger than 10 mm in diameter. Therefore this imaging technique is not (yet) suitable as a screening test. Additional limitations are the necessary cooperation of the patient which can reduce the practicability and image quality in selected patients. Further studies like the just started German multicentre trial are needed to assess the position of MR colonography.
Kerker
J
J
Klinik für Innere Medizin I, Abteilung für Gastroenterologie und Hepatologie, Alfried-Krupp-Krankenhaus, Essen. jens.kerker@krupp-krankenhaus.de
Albes
G
G
Roer
N
N
Montag
M
M
Budde
T
T
Schaefer
A
A
D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003111:Colonic Polyps / Q000175:diagnosis* / Q000000981:diagnostic imaging; D023881:Colonography, Computed Tomographic; D003113:Colonoscopy; D003287:Contrast Media; D003627:Data Interpretation, Statistical; D004733:Enema; D005240:Feasibility Studies; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007297:Inpatients; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014867:Water
D003287:Contrast Media; D014867:Water; D019786:Gadolinium DTPA