Rodriguez Gomez Sonia, Pagés Llinas Mario, Castells Garangou Antoni, De Juan Garcia Carmen, Bordas Alsina Josep M, Rimola Gibert Jordi, Ayuso Colella Juan R, Ayuso Colella Carmen
Department of Radiology, Hospital Clinico of Barcelona, Villarroel, 170, 08036 Barcelona, Spain.
Eur Radiol. 2008 Jul;18(7):1396-405. doi: 10.1007/s00330-008-0900-6. Epub 2008 Mar 5.
The purpose was to evaluate MR colonography (MRC) with barium fecal tagging in detecting colorectal pathology and to determine how air-based and water-based colonic distension influences MRC. We studied 83 patients with high risk of colonic neoplasms. All received oral barium sulfate for colonic preparation before unenhanced and enhanced T1-weighted gradient-echo MRC using either water (n=54) or air (n=29) for colonic distension. Fecal tagging, distension, and artifacts were recorded. All patients underwent conventional colonoscopy within 2 weeks of MRC; the techniques were compared for detection of malignant neoplasms and polyps >or=1 cm, 6-9 mm, and <or=5 mm. Fecal tagging was "good" in 76% of the colonic segments in water-distended patients and 46% of air-distended patients. The degree of distension was "good" in 90.7% of water-distended patients and 44% of air-distended patients. Severe artifacts were present in 15% air-distended patients and 0.3% of water-distended patients. Both water-distended and air-distended MRC detected all malignant neoplasms and polyps >or=1 cm, but more air-distended MRC were excluded for poor quality. MRC with fecal tagging is useful for detecting lesions >or=1 cm. Air distension was inferior to water distension in most aspects. Water-based colonic distension should be used for barium-tagging MRC.
本研究旨在评估钡剂粪便标记的磁共振结肠成像（MRC）在检测结直肠病变中的应用，并确定基于空气和基于水的结肠扩张对MRC的影响。我们研究了83例患结肠肿瘤风险较高的患者。所有患者在使用水（n = 54）或空气（n = 29）进行结肠扩张的未增强及增强T1加权梯度回波MRC检查前，均口服硫酸钡进行结肠准备。记录粪便标记、扩张情况及伪影。所有患者在MRC检查后2周内接受传统结肠镜检查；比较两种技术对恶性肿瘤及直径≥1 cm、6 - 9 mm和≤5 mm息肉的检测情况。在水扩张患者中，76%的结肠段粪便标记“良好”，在空气扩张患者中为46%。90.7%的水扩张患者扩张程度“良好”，空气扩张患者为44%。15%的空气扩张患者出现严重伪影，水扩张患者为0.3%。水扩张和空气扩张的MRC均检测出所有直径≥1 cm的恶性肿瘤和息肉，但更多空气扩张的MRC因质量差被排除。有粪便标记的MRC对检测直径≥1 cm的病变有用。在大多数方面，空气扩张不如水扩张。基于水的结肠扩张应用于钡剂标记的MRC检查。
