TITLE:
Comparison of a New Magnetic Resonance Imaging Protocol and Magnetic Resonance Follow-Through in Patients with Inflammatory Bowel Disease—A Prospective Pilot Study
AUTHORS:
Kayalvily Jesuratnam-Nielsen, Vibeke B. Løgager, Pia Munkholm, Yousef W. Nielsen, Henrik S. Thomsen
KEYWORDS:
Crohn’s Disease, Faecal Calprotectin, Inflammatory Bowel Disease, Magnetic Resonance Imaging, Ulcerative Colitis
JOURNAL NAME:
Open Journal of Radiology,
Vol.5 No.2,
June
30,
2015
ABSTRACT: Objective: Inflammatory bowel disease (IBD) is a chronic disease, consisting of two main subgroups: Crohn’s disease (CD) and ulcerative colitis (UC). Imaging is an essential component in the treatment of IBD and is used repeatedly to determine activity and severity of inflammatory lesions. The aim of our study was to prospectively obtain pilot data on the accuracy of magnetic resonance imaging with no oral contrast (MRI-NOC) and magnetic resonance follow-through (MRFT) using endoscopy as the reference standard. Materials and Methods: Patients diagnosed with CD and UC referred to magnetic resonance imaging (MRI) were included in this study population. For the evaluation, the bowel was divided into 9 segments. Two radiologists, blinded to clinical findings, evaluated bowel wall thickness, diffusion weighted imaging and mural hyperenhancement. Results: 14 patients (9 males and 5 females; median age 41; range 20 - 62) underwent both type of MRI examinations; 9 had CD and 5 had UC. The overall sensitivity for small bowel was zero for both MRI protocols, as neither identified any lesions, whereas in colon the sensitivity ranged from 7% to 29% in MRI-NOC and 14% - 29% in MRFT. Specificity and accuracy in MRI-NOC ranged from 78% to 98% and 74% - 93%, respectively, in small bowel, and from 90% to 96% and 77% - 82%, respectively, in colon. Specificity and accuracy in MRFT ranged from 83% to 100% and 79% - 95%, respectively, in small bowel, while it ranged from 93% to 97% and 81% - 85%, respectively, in colon. Conclusion: The location of lesions in the colon combined with the lack of oral contrast in the colon renders MRFT and MRI-NOC functionally identical.