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MR Colonography with Barium-based Fecal Tagging: Initial Clinical Experience¹

¹ From the Departments of Diagnostic Radiology (T.C.L., S.C.G., S.G.R., J.F.D.) and Gastroenterology and Hepatology (G.H.), University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany. Received May 4, 2001; revision requested June 8; revision received August 22; accepted October 10. Address correspondence to T.C.L. (e-mail: thomas.lauenstein@uni-essen.de).

View larger version (127K): [in a new window]   Figure 1a. MR colonographic images obtained in a 48-year-old man undergoing MR colonography with fecal tagging. (a) Coronal source image from 3D gradient-echo data set (1.64/0.6, 15° flip angle) collected after administration of water enema and 75 seconds after completion of intravenous administration of gadobenate dimeglumine (0.2 mmol/kg) shows that after fecal tagging, the colonic lumen is homogeneously dark, while stool is sufficiently dark to blend into administered water enema. (b) Contrast between dark lumen and bright colonic wall is sufficient for virtual endoscopic rendering.

View larger version (169K): [in a new window]   Figure 1b. MR colonographic images obtained in a 48-year-old man undergoing MR colonography with fecal tagging. (a) Coronal source image from 3D gradient-echo data set (1.64/0.6, 15° flip angle) collected after administration of water enema and 75 seconds after completion of intravenous administration of gadobenate dimeglumine (0.2 mmol/kg) shows that after fecal tagging, the colonic lumen is homogeneously dark, while stool is sufficiently dark to blend into administered water enema. (b) Contrast between dark lumen and bright colonic wall is sufficient for virtual endoscopic rendering.

View larger version (133K): [in a new window]   Figure 2. MR colonographic image with fecal tagging (1.64/0.6, 15° flip angle), obtained in a 71-year-old man, shows bright stool in transverse colon (arrows) that is of similar signal intensity to enhancing colonic wall. This patient did not comply with the food restriction. Enhancing lesions protruding into colonic lumen cannot be excluded.

View larger version (128K): [in a new window]   Figure 3a. Polyp in the sigmoid colon of a 56-year-old man. (a, b) 3D gradient-echo data set (1.64/0.6, 15° flip angle) collected after administration of water enema and intravenous gadobenate dimeglumine depicts enhancing 12-mm lesion (arrow) arising from enhancing colonic wall in the sigmoid colon (shown in coronal and transverse planes). (c) Virtual endoscopic rendering confirms polyp.

View larger version (104K): [in a new window]   Figure 3b. Polyp in the sigmoid colon of a 56-year-old man. (a, b) 3D gradient-echo data set (1.64/0.6, 15° flip angle) collected after administration of water enema and intravenous gadobenate dimeglumine depicts enhancing 12-mm lesion (arrow) arising from enhancing colonic wall in the sigmoid colon (shown in coronal and transverse planes). (c) Virtual endoscopic rendering confirms polyp.

View larger version (130K): [in a new window]   Figure 3c. Polyp in the sigmoid colon of a 56-year-old man. (a, b) 3D gradient-echo data set (1.64/0.6, 15° flip angle) collected after administration of water enema and intravenous gadobenate dimeglumine depicts enhancing 12-mm lesion (arrow) arising from enhancing colonic wall in the sigmoid colon (shown in coronal and transverse planes). (c) Virtual endoscopic rendering confirms polyp.

View larger version (115K): [in a new window]   Figure 4a. Images show 3.5-cm mass (arrows) arising from enhancing colonic wall of ascending colon in a 65-year-old woman. (a) Single coronal source image from 3D gradient-echo data set (1.64/0.6, 15° flip angle) collected after administration of water enema and intravenous gadobenate dimeglumine. (b) Virtual endoscopic rendering confirms carcinoma.

View larger version (169K): [in a new window]   Figure 4b. Images show 3.5-cm mass (arrows) arising from enhancing colonic wall of ascending colon in a 65-year-old woman. (a) Single coronal source image from 3D gradient-echo data set (1.64/0.6, 15° flip angle) collected after administration of water enema and intravenous gadobenate dimeglumine. (b) Virtual endoscopic rendering confirms carcinoma.

View larger version (136K): [in a new window]   Figure 5. MR colonographic image obtained in a 69-year-old man shows hepatic metastasis (arrow), subsequently confirmed at surgery. Coronal source image from 3D gradient-echo data set (1.64/0.6, 15° flip angle).