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Gastrointestinal Imaging |
1 From the Institute of Diagnostic Radiology (W.L., S.W., B.M., J.F.D.) and the Department of Internal Medicine, Section of Gastroenterology (P.B., M.F.), University Hospital Zurich, Switzerland. Received June 21, 1999; revision requested August 10; final revision received November 9; accepted November 16. Supported in part by German Research Society grant DFG Lu 687/1-1. Address correspondence to J.F.D., Department of Radiology, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany (e-mail: debatin@uni-essen.de).
PURPOSE: To assess magnetic resonance (MR) colonography as a method for detection of colorectal masses, with conventional colonoscopy as the reference standard.
MATERIALS AND METHODS: MR colonography was performed in 132 patients referred for colonoscopy because of the possible presence of a mass. After rectal filling with a gadopentetate dimeglumine and water enema, T1-weighted three-dimensional gradient-echo MR studies were acquired with the patient in the prone and supine positions. Water-sensitive single-shot fast spin-echo MR images were also obtained. Surface-rendered virtual endoscopic endoluminal views, orthogonal sections in three planes, and water-sensitive MR images were interactively assessed for presence of colorectal masses by two radiologists.
RESULTS: MR colonography was well tolerated without sedation or analgesia. MR image quality was sufficient for diagnosis in 127 (96%) patients. Most small (
5-mm-diameter) masses were overlooked at MR colonography, but 19 of 31 6–10-mm lesions and 26 of 27 large (>10-mm) lesions were correctly identified. For these large masses, MR colonography had a sensitivity of 93%, specificity of 99%, positive predictive value of 92%, and negative predictive value of 98% for detection of masses.
CONCLUSION: MR colonography is a promising modality for help in detecting colorectal mass lesions larger than 10 mm in diameter.
Index terms: Colon, MR, 75.121411, 75.121412, 75.12143, 75.12149 • Colon neoplasms, 75.311, 75.32 • Colon neoplasms, diagnosis • Magnetic resonance (MR), three-dimensional, 75.121411, 75.121412, 75.12143, 75.12149
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