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MR Colonography Without Colonic Cleansing

A New Strategy to Improve Patient Acceptance

¹ Department of Diagnostic Radiology, University Hospital Essen, Hufelandstr. 55, D-45122 Essen, Germany.
² Department of Gastroenterology and Hepatology, University Hospital Essen, D-45122 Essen, Germany.

View larger version (131K): [in a new window]   Fig. 1. —Coronal source MR image of three-dimensional gradient-echo set collected after administration of barium sulfate enema and 75 sec after completion of IV administration of gadobenate dimeglumine (0.2 mmol/kg) in healthy 29-year-old male volunteer who had not undergone fecal tagging. Bright stool in transverse colon in untagged volunteer is of similar signal intensity to that of enhancing colonic wall. Enhancing lesions protruding into colonic lumen cannot be excluded.

View larger version (104K): [in a new window]   Fig. 2A. —MR image of healthy 31-year-old male volunteer after fecal tagging protocol. Coronal source image of three-dimensional gradient-echo data set shows that after fecal tagging colonic lumen is homogeneously dark, whereas stool is sufficiently dark to blend into administered barium enema.

View larger version (130K): [in a new window]   Fig. 2B. —MR image of healthy 31-year-old male volunteer after fecal tagging protocol. Virtual endoscopic rendering shows that contrast between dark lumen and brightly enhancing colonic wall is sufficient to allow this form of endoscopic rendering. Arrow marks direction of virtual fly through.

View larger version (137K): [in a new window]   Fig. 3A. —33-year-old woman with polyp in sigmoid colon. Single coronal source MR image of three-dimensional gradient-echo data set collected after administration of barium enema and IV gadobenate dimeglumine depicts enhancing 10-mm lesion arising from enhancing colonic wall in sigmoid colon (arrow).

View larger version (113K): [in a new window]   Fig. 3B. —33-year-old woman with polyp in sigmoid colon. Virtual endoscopic rendering confirms presence of 10-mm polyp. Arrow marks direction of virtual fly through.

View larger version (133K): [in a new window]   Fig. 3C. —33-year-old woman with polyp in sigmoid colon. Photograph at colonoscopy shows polyp that was subsequently removed.

View larger version (106K): [in a new window]   Fig. 4. —Single coronal source MR image of three-dimensional gradient-echo data set of 71-year-old woman collected after administration of barium enema and IV gadobenate dimeglumine depicts 2-cm mass (arrow) arising from enhancing colonic wall of transverse colon proximal to splenic flexure. Histology confirmed presence of carcinoma.

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