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DOI: 10.1148/radiol.2451061244
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(Radiology 2007;245:150-159.)
© RSNA, 2007

Gastrointestinal Imaging

MR Colonography with Limited Bowel Preparation: Patient Acceptance Compared with That of Full-Preparation Colonoscopy1

Jasper Florie, MD, PhD, Erwin Birnie, PhD, Rogier E. van Gelder, MD, PhD, Sebastiaan Jensch, MD, Brigitte Haberkorn, MD, Joep F. Bartelsman, MD, Annet van der Sluys Veer, MD, Pleun Snel, MD, PhD, Victor P. M. van der Hulst, MD, PhD, Gouke J. Bonsel, PhD, Patrick M. M. Bossuyt, PhD, and Jaap Stoker, MD, PhD

1 From the Departments of Radiology (J.F., R.E.v.G., S.J., B.H., J.S.), Public Health Epidemiology (E.B., G.J.B.), Gastroenterology and Hepatology (J.F.B.), and Clinical Epidemiology & Biostatistics (P.M.M.B.), Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Departments of Radiology (S.J., V.P.M.v.d.H.) and Gastroenterology (A.v.d.S.V.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; and Department of Gastroenterology, Slotervaart Hospital, Amsterdam, the Netherlands (P.S.). Received July 22, 2006; revision requested July 27; revision received December 9; accepted January 15, 2007; final version accepted March 7. Supported by grant 2100.0094 from the Netherlands Organization for Health Research and Development. Address correspondence to J.F. (e-mail: j.florie{at}amc.uva.nl).

Purpose: To prospectively evaluate participants' experience and preference of magnetic resonance (MR) colonography with limited bowel preparation compared with full-preparation colonoscopy in participants at increased risk for colorectal cancer.

Materials and Methods: This study had institutional review board approval; all participants gave written informed consent. In this multicenter study, consecutive participants undergoing conventional colonoscopy because of a personal or family history of colorectal cancer or adenomatous polyps underwent MR colonography 2 weeks prior to colonoscopy. They all followed a low-fiber diet and were given lactulose and an oral contrast agent (fecal tagging with gadolinium) 2 days before colonography. Before imaging, spasmolytics were administered intravenously, and a water–gadolinium chelate mixture was administered rectally for distention of the colon. Breath-hold T1- and T2-weighted sequences were performed in the prone and supine positions. Participant experience in terms of, for example, pain and burden was determined by using a five-point scale and was evaluated with a Wilcoxon signed rank test; participant preference was determined by using a seven-point scale and was evaluated with the {chi}2 statistic after dichotomizing.

Results: Two hundred nine participants (77 women, 132 men; mean age, 58 years; range, 23–84 years) were included. One hundred forty-eight participants received sedatives (midazolam) and/or analgesics (fentanyl) during colonoscopy. Participants rated the MR colonography bowel preparation as less burdensome (P < .001) compared with the colonoscopy bowel preparation (10% and 71% of participants rated the respective examinations moderately to extremely burdensome). Participants also experienced less pain at MR colonography (P < .001) and found MR colonography less burdensome (P < .001). Immediately after both examinations, 69% of participants preferred MR colonography, 22% preferred colonoscopy, and 9% were indifferent (P < .001, 69% vs 22%). After 5 weeks, 65% preferred MR colonography and 26% preferred colonoscopy (P < .001).

Conclusion: Participants preferred MR colonography without extensive cleansing to colonoscopy immediately after both examinations and 5 weeks later. Experience of the bowel preparation and of the procedure was rated better.

© RSNA, 2007




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