Zhang Shuai, Peng Jun-Wei, Shi Qiang-Ying, Tang Feng, Zhong Min-Guo
Department of Radiology, Fudan University Cancer Hospital Shanghai 200032, China.
World J Gastroenterol. 2007 Oct 28;13(40):5371-5. doi: 10.3748/wjg.v13.i40.5371.
To assess Magnetic resonance colonography with fat enema as a method for detection of colorectal neoplasm.
Consecutive twenty-two patients underwent MR colonography with fat enema before colonoscopy. T1-weighted three-dimensional fast spoiled gradient-echo with inversion recovery sequence was acquired with the patient in the supine position before and 75 s after Gadopentetate Dimelumine administration. Where by, pre and post MR coronal images were obtained with a single breath hold for about 20 s to cover the entire colon. The quality of MR colonographs and patients' tolerance to fat contrast medium was investigated. Colorectal neoplasms identified by MR colonography were compared with those identified on colonoscopy and sensitivity of detecting the lesions was calculated accordingly.
MR colonography with fat enema was well tolerated without sedation and analgesia. 120 out of 132 (90.9%) colonic segments were well distended and only 1 (0.8%) colonic segment was poor distension. After contrast enhancement scan, mean contrast-to-noise ratio (CNR) value between the normal colonic wall and lumen was 18.5 +/- 2.9 while mean CNR value between colorectal neoplasm and lumen was 20.2 +/- 3.1. By Magnetic resonance colonography, 26 of 35 neoplasms (sensitivity 74.3%) were detected. However, sensitivity of MRC was 95.5% (21 of 22) for neoplasm larger than 10 mm and 55.6% (5 of 9) for 5-10 mm neoplasm.
MR colonography with fat enema and T1-weighted three-dimensional fast spoiled gradient-echo with inversion recovery sequence is feasible in detecting colorectal neoplasm larger than 10 mm.
评估脂肪灌肠磁共振结肠成像作为检测结直肠肿瘤的一种方法。
连续22例患者在结肠镜检查前接受脂肪灌肠磁共振结肠成像。在给予钆喷酸葡胺前及给药后75秒，患者仰卧位时采用T1加权三维快速扰相梯度回波反转恢复序列进行扫描。在此过程中，通过单次屏气约20秒获取磁共振冠状位前后图像以覆盖整个结肠。研究磁共振结肠成像的质量以及患者对脂肪对比剂的耐受性。将磁共振结肠成像发现的结直肠肿瘤与结肠镜检查发现的肿瘤进行比较，并据此计算病变检测的敏感性。
脂肪灌肠磁共振结肠成像在无需镇静和镇痛的情况下耐受性良好。132个结肠段中有120个（90.9%）扩张良好，只有1个（0.8%）结肠段扩张不佳。对比增强扫描后，正常结肠壁与肠腔之间的平均对比噪声比（CNR）值为18.5±2.9，而结直肠肿瘤与肠腔之间的平均CNR值为20.2±3.1。通过磁共振结肠成像，35个肿瘤中有26个（敏感性74.3%）被检测到。然而，对于大于10mm的肿瘤，磁共振结肠成像的敏感性为95.5%（22个中的21个），对于5 - 10mm的肿瘤，敏感性为55.6%（9个中的5个）。
脂肪灌肠磁共振结肠成像及T1加权三维快速扰相梯度回波反转恢复序列在检测大于10mm的结直肠肿瘤方面是可行的。
