Background and Study Aims: The purpose of this study was to evaluate dark-lumen magnetic resonance (MR) colonography
prospectively in patients with incomplete conventional colonoscopy.Patients and Methods: Thirty-two patients with incomplete conventional colonoscopy underwent same-day dark-lumen
MR colonography on the basis of a standard protocol. The depiction of colorectal diseases
was assessed in the following colon segments: cecum, ascending colon, transverse colon,
descending colon, sigmoid colon, and rectum. The reasons for incomplete colonoscopy
included high-grade stenosis in 26 patients (four with occlusive cancer, 12 with fibrotic
stenosis based on recurrent sigmoid diverticulitis, eight with Crohn’s-induced stenosis,
and two with nonsteroidal anti-inflammatory drug colonopathy), extreme patient intolerance
in one patient, and technical challenges associated with an elongated colon in five
patients. The results of MR colonography were compared with the findings of the initial
conventional colonoscopy, the histopathological outcome, and follow-up colonoscopy
when possible.Results: All high-grade stenoses were confirmed on MR colonographic data sets. Of the 26 patients
with high-grade stenosis, 19 underwent surgery with histopathological confirmation
of the initial diagnosis. Follow-up colonoscopy was carried out in 14 patients with
surgically treated high-grade stenosis. In six of these 14 patients, nine polyps identified
at the initial MR colonography were confirmed and removed during a postoperative conventional
colonoscopy. Two polyps (5 mm and 8 mm in diameter) identified on postoperative conventional
colonoscopy had not been seen preoperatively at MR colonography. One polyp seen on
MR colonography was not identified in the follow-up colonoscopy.Conclusion: Dark-lumen MR colonography is a feasible and useful method of evaluating the entire
colon in patients with incomplete conventional colonoscopy.
References
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