Magnetic resonance colonography with automated carbon dioxide insufflation: Diagnostic accuracy and distension

M. P. van der Paardt, F. M. Zijta, T. N. Boellaard, S. Jensch, L. C. Baak, A. C. T. M. Depla, E. Dekker, A. J. Nederveen, S. Bipat, J. Stoker

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Abstract

To evaluate the diagnostic performance of MR colonography using automated carbon dioxide (CO2) insufflation for colonic distension, with colonoscopy serving as the reference standard. Ninety-eight symptomatic patients underwent MR colonography with faecal tagging and automated CO2 insufflation. Three readers (one expert (reader 1), and two less experienced (readers 2 and 3)) evaluated the images for the presence of colorectal lesions. Bowel distension was evaluated on a 4-point scale. Results were verified with colonoscopy and histopathological analysis. Per-patient sensitivity for lesions ≥10mm was 91.7% (11 of 12) (reader 1), 75.0% (9 of 12) (reader 2), and 75% (9 of 12) (reader 3). Specificity was 96.5% (82 of 85) (reader 1), 97.7% (83 of 85) (reader 2), 95.3% (81 of 85) (reader 3). Per-patient sensitivity for lesions ≥6mm was 85.7% (18 of 21) (reader 1), 57.1% (12 of 21) (reader 2), and 57.1% (12 of 21) (reader 3). Specificity was 86.8% (66 of 76), 98.7% (75 of 76), 90.8% (69 of 76), respectively. Per-patient sensitivity for advanced neoplasia of ≥10mm and ≥6mm was 88.9% (8 of 9) for all readers. Specificity for ≥10mm and ≥6mm was 98.9% (87 of 88) (reader 1), 97.7% (86 of 88) (reader 2), 96.6% (85 of 88) (reader 3). 94.4% of the colon segments were adequate to optimal distended with dual positioning. MR colonography can accurately detect lesions ≥10mm, and advanced neoplasia ≥6mm. Sufficient distension was achieved using automated CO2 insufflation for colonic distension in MR colonography
Original languageEnglish
Pages (from-to)743-750
JournalEuropean Journal of Radiology
Volume83
Issue number5
DOIs
Publication statusPublished - 2014

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