Magnetic Resonance Imaging for the diagnosis and management of acute colonic diverticulitis: a review of current and future use

Abstract

Diverticular disease is one of the most common causes of outpatient visits and hospitalisations across Australia, North America and Europe. According to the Gastroenterological Society of Australia (GESA, 2010), approximately 33% of Australians over 45 years of age and 66% over 85 years of age have some form of colonic diverticulosis. Patients with colonic diverticulosis are known to develop subsequent complications such as acute colonic diverticulitis (ACD), and when more than one attack of diverticulitis occurs, there is a 70-90% chance that the individual will experience ongoing problems and recurring infections throughout their lifetime. Medical imaging is fundamental in the diagnosis, treatment and ongoing management of ACD and its complications, with Computed Tomography (CT) identified as the prevailing gold standard in the last few decades. Cross-database searching highlighted a large gap in the literature regarding the effectiveness of Magnetic Resonance Imaging (MRI) as a non-ionising radiation alternative imaging tool for ACD imaging after the mid-2000s, despite ongoing technological advancements in this modality. This narrative review identified 13 key publications (11 primary prospective cohort studies, 1 systematic review and 1 meta-analysis) that evaluate MRI for ACD imaging, of which five were published within the last decade. Several existing MRI protocols are deemed suitable for ACD imaging, and it is recommended they be re-evaluated in larger cohorts. Future studies should consider the rapidly growing technological improvements of MRI, its cost efficiency and its applicability in modern day healthcare settings when addressing ACD management. This is especially important considering the gradual rise in radiation dose among the Australian population attributable to increased CT referrals, alongside increased reporting of ACD cases in younger individuals.

Teaching evidence-based practice: Case study of an integrated assessment task for diagnostic radiography students

“…Since the integration and refinement of the learning and assessment task, students have engaged with the profession beyond the university context. We provided a solid platform for our students to contribute advanced knowledge to the wider DR community [26][27][28][29][30][31] . A proportion of students increased clinical and research knowledge through the critical analysis and development of evidence-based imaging pathways which have been disseminated at national conference presentations and in journal publications in a radiography practice journal, [26][27][28][29][30][31] demonstrating both the quality of the work developed by the students and the relevance of the assessment to a wider professional audience.…”

“…Students had the opportunity to contribute advanced knowledge to the wider DR community, in the form of submission to professional conference presentations and submission to peer-reviewed journals. Success in this area was evident, with students presenting their literature review findings in the Australian Society of Medical Imaging and Radiation Therapy student and national conferences, [26][27][28][29] as well as publications in a professional peer-reviewed journal [30,31] .…”

Magnetic Resonance Imaging of the Gastrointestinal Tract: Current Role, Recent Advancements and Future Prospectives

“…In the diagnosis of diverticulitis, thanks to its superior soft tissue contrast resolution, MRI allows a very precise identification of pathological changes: the presence of pericolonic fat inflammation, thickening and inflammation of the intestinal wall, mesenteric infiltration, stenosis of colonic segments, and size of diverticula; moreover, contrast-enhanced MRI may be helpful in the differentiation of colonic diverticulitis from primary colonic carcinoma [22][23][24].…”