Pasquale Paolantonio MD, Presenter: Nothing to Disclose

Andrea Laghi MD, Abstract Co-Author: Nothing to Disclose

Franco Iafrate MD, Abstract Co-Author: Nothing to Disclose

Michela Celestre MD, Abstract Co-Author: Nothing to Disclose

Salvatore Cucchiara MD, Abstract Co-Author: Nothing to Disclose

Roberto Passariello MD, Abstract Co-Author: Nothing to Disclose

to evaluate the accurancy of MR-colonography performed without colonic cleasing by means of fecal tagging using oral administration of barium sulfate in a pediatric population with suspected IBD using conventional colonoscopy as standart of reference.

20 paediatric patients with suspected IBD were enrolled in the study. Each patient underwent conventional colonoscopy. Fecal tagging was performed by the oral administration of a fixed amount of 150 ml of highly-concentrated barium-sulfate at major meals starting 3 days before MR examination. Immediately before the examination the colon was distended by a water enema. MR imaging protocol included T2w HASTE (TR, inf; TE, 90msec; FA, 180°; acq time, 20 sec) and contrast enhanced T1w 3D-VIBE (TR, 5,2 msec; TE, 2,6 msec; FA, 20°, acq time, 18 sec) and T1w 2D-turboFLASH (TR/TE/FA/TI: 8,5 msec, 4 mesc, 10°, 10 msec) sequences. Contrast enhancement was obtained by i.v injection of 0.1 mmol/kg b.w. ml of Gd-chelate. A semiquantitative analysis was performed from two radiologist in a blind consensus fashion. For each patient a specific MR score was calculated on the basis of colonic wall thickness and post-contrast enahncement. The MR score was compared with a qualitative well assessed endoscopic score using the Spearman rank test.

Final diagnosis was Crohn’s disease in 4 cases and ulcerative colitis in 7 cases. In 9 of these patients MR correctly defined thickening of the colonic wall and localization and extension of the inflammed bowel wall, by means of contrast enhancement following Gd-chelate injection. In 9 patients served as control group MR did not show any sign of colonic wall infllammation. An optimal correlation between MR and endoscopic score was observed (r: 0,90) with a SE of 81% and a SP of 100%.

Unprepped MR colonography by barium fecal tagging is a well tolerated diagnostic method in the evaluation of colonic involvement in pediatric patients with IBD and rapresents a promising tool in the recruitment of patients for conventional colonoscopy and in therapy response assesment.

Paolantonio, P, Laghi, A, Iafrate, F, Celestre, M, Cucchiara, S, Passariello, R, Un-prepped MR Colonography in Paediatric Patients with Suspected Inflammatory Bowel Disease (IBD): A Comparison Study with Conventional Colonoscopy.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4412198.html