Abstract Archives of the RSNA, 2003
Francesca Maccioni MD, PRESENTER: Nothing to Disclose
Purpose: To investigate the diagnostic value of MRI in the assessment of Ulcerative Colitis (UC) in comparison with endocoscopy and /or surgery.
Methods and Materials: 27 consecutive patients with UC underwent MRI. In 11/27endoscopy was incomplete or impossible to perform due to strictures. MRI was performed after oral administration of a superparamagnetic contrast agent, using standard sequences (HASTE T2-weighted, with and without fat-suppression and Gd-enhanced T1-weighted FLASH). The colon was distended by air in 17/27 pts. Morphological evaluation included disease extension, bowel wall thickness, lost of haustration, widening of the recto-sacral space, presence of strictures and any other complication; inflammatory activity was assessed by considering the degree of wall Gd-enhancement and T2-signal. For morphological evaluation Gold Standards (GS) were endoscopy and/or surgery, whereas pathology specimens were GS for disease activity.
Results: Nine patients underwent surgery. MRI correctly assessed the extension of the disease in 22/27 pts; in 4 pts the disease was underestimated respect to colonoscopy, in 1 cases was not detected at all (quiescent disease). All patients with severe to moderate disease were correctly evaluated by MRI. The T2-signal and Gd-enhancement of the wall was found related with the degree of endoscopic and pathologic activity in 85% of the patients. In 12% of patients MRI showed complications (tight strictures, adhesions, 2 ovarian involvements). In 15% of patients MRI significantly affected the surgical planning.
Conclusion: MRI can offer reliable information on the different aspects of UC (extension, activity and complication).
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Maccioni MD, F,
Colaiacomo MD, M,
Bruni MD, A,
D'Avanzo MD, M,
Stasolla MD, A,
Marini MD, M,
Role of MR Imaging in the Clinical Management of Patients with Ulcerative Colitis. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3104614.html