Colonic Masses: Detection with MR Colonography

Luboldt, Wolfgang; Bauerfeind, Peter; Wildermuth, Simon; Marinček, Borut; Fried, Michael; Debatin, Jörg F.

doi:10.1148/radiology.216.2.r00au11383

Cited by 149 publications

(86 citation statements)

References 35 publications

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“…Cross sectional imaging techniques including magnetic resonance imaging (MRI) and computed tomography (CT) are increasingly being considered as alternative imaging modalities for colorectal screening [1,2]. Using thin section axial images and assigned software both techniques allow the generation of three-dimensional views of the colon, simulating those obtained with conventional colonoscopy.…”

Section: Introductionmentioning

confidence: 99%

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Colorectal polyps: Detection with multi-slice CT colonography

Weßling

Fischbach²,

Domagk³

et al. 2001

Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr

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Summary. Purpose: To compare the performance of virtual and conventional colonoscopy for the detection of colorectal polyps using a multislice spiral CT scanner (MSCT). Materials and Methods: 48 patients (20 women, 28 men, mean age 61.5 years) with clinical indication for conventional colonoscopy were prospectively studied using a MSCT (Somatom Volume Zoom, Siemens, Forchheim). Examination was performed after standard oral preparation for colonoscopy and colonic distension with room air and i. v. butylscopolamin. Images were obtained in prone and supine position using a detector configuration of 4 1 mm, a table feed of 5 mm/rotation at 140 mAs and 120 kV. Slice thickness and reconstruction increment were 3 and 1.5 mm, respectively. CT data were assessed by two blinded radiologists on a Vitrea workstation (Vital Images, USA) using a software with multiplanar and volume-rendering capabilities. Results: 33 patients had normal findings on conventional colonoscopy. In 15 patients a total of 30 polyps and one carcinoma with stenosis were identified. MSCT-colonography identified the carcinoma and 23 polyps (77 %). 3 of 3 polyps were 10 mm or more (100 %), 6 of 7 were 5.1 to 9.9 mm (86 %) and 14 of 20 were 5 mm or smaller (70 %). There were 13 false positive findings for polyps (10 lesions < 6 mm in 5 patients) and no false positive finding of carcinoma. Conclusions: MSCT colonography allows accurate detection of polyps larger than 10 mm. Compared to published results of single-slice CT, multislice CT colonography increases the rate of detection of small colorectal polyps in particular. However, false positive results still remain a problem. Schlüsselwörter: Polypen ± Computertopographie ± Kolographie ± Mehrschicht-CT

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Section: Introductionmentioning

confidence: 99%

“…MRI as well as singleslice CT suffer from restrictions in spatial resolution and motion artefacts, which explain insufficient detection rates for masses smaller than 10 mm [2]. Single-slice CT requires several breath holds or a slice thickness exceeding 4 mm in order to scan the entire colon.…”

Section: Introductionmentioning

confidence: 99%

Colorectal polyps: Detection with multi-slice CT colonography

Weßling

Fischbach²,

Domagk³

et al. 2001

Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr

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“…Bright lumen MRC, which has been shown to be accurate in detecting colorectal polyps larger than 8 mm in size, requires the administration of a gadolinium-containing rectal enema [6,8,9]. Although most authors suggest a mixture of 1 : 100 [6], some studies recommend the use of a 1 : 50 Gd/water dilution [8].…”

Section: Discussionmentioning

confidence: 99%

“…Although most authors suggest a mixture of 1 : 100 [6], some studies recommend the use of a 1 : 50 Gd/water dilution [8]. Assuming a colonic volume of 3000 ml, between 30 and 60 ml of costly paramagnetic contrast are needed for the rectal enema alone.…”

Section: Discussionmentioning

confidence: 99%

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Dark lumen MR-Colonography: initial experience

Lauenstein¹,

Herborn²,

Vogt³

et al. 2001

Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr

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MR colonography: How does air compare to water for colonic distention?

Ajaj¹,

Lauenstein²,

Pelster³

et al. 2004

Magnetic Resonance Imaging

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Purpose:To prove the feasibility of air-distended magnetic resonance colonography (MRC) and compare it with waterbased distention. Materials and Methods:In five volunteers, the colon was imaged twice: once after distending the colon with air and a second time after distending the colon with water. A total of 50 patients, who had been referred to colonoscopy for a suspected colorectal pathology were randomized into water-distention (N ϭ 25) and air-distention (N ϭ 25) groups. A contrast-enhanced T1-weighted three-dimensional volume interpolated breath-hold (VIBE) sequence was collected. Comparative analysis was based on qualitative ratings of image quality and bowel distention, as well as contrast-to-noise ratio (CNR) measurements for the colonic wall with respect to the colonic lumen. In addition, patient acceptance was evaluated.Results: Inflammatory changes and colorectal masses were correctly identified on MRC in eight patients each. One 4-mm polyp identified at colonoscopy was missed on waterdistended MRC. There were no false positive findings. No significant differences were found between air-and waterdistention regarding discomfort levels and image quality. The presence of air in the colonic lumen was not associated with susceptibility artifacts. CNR of the contrast-enhanced colonic wall, as well as bowel distention, were superior on air-distended three-dimensional data sets. Conclusion:MRC can be performed using either water or air for colonic distention. Both techniques permit assessment of the colonic wall and identification of colorectal masses. While discomfort levels are similar for both agents, MRC with air provides higher CNR and better colonic distention. MAGNETIC RESONANCE (MR) colonography (MRC) has been shown to be an appropriate diagnostic tool for the detection of pathologies, including colorectal masses, diverticula, and inflammatory disease (1-4). Reliable assessment of the colon by means of MR imaging is predicated upon the fulfillment of two requirements: sufficient distention of the colonic lumen and sufficient contrast between the colonic lumen and pathologies arising from the colonic wall. Hence, the cleansed colon is filled either with liquid, such as tap water, with or without the addition of paramagnetic contrast (2,5,6), or gaseous agents, such as room air, CO 2 , and hyperpolarized helium (7-9). While initial experience was based on techniques rendering the colonic lumen bright, dark lumen MRC has recently been found to be advantageous (1,3).The fear of compromised image quality due to susceptibility effects at air/tissue interfaces has long favored the use of water or water-based solutions for colonic distention in MRC (6,10). With the availability of high performance gradients permitting data acquisition with very short echo times, the potential of relevant susceptibility effects is reduced. Accordingly, interest in the use of gaseous agents has grown. They avoid the risk of spillage and have been suggested to be associated with less discomfort compared to fluid (7,8).The purpos...

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Colonic Masses: Detection with MR Colonography

Abstract: MR colonography is a promising modality for help in detecting colorectal mass lesions larger than 10 mm in diameter.

Cited by 149 publications

References 35 publications

Colorectal polyps: Detection with multi-slice CT colonography

Colorectal polyps: Detection with multi-slice CT colonography

Dark lumen MR-Colonography: initial experience

MR colonography: How does air compare to water for colonic distention?

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