MAGNETIC-RESONANCE-IMAGING IN INFLAMMATORY BOWEL-DISEASE

Magnetic resonance (MR) images were acquired in 28 consecutive inflamm atory bowel disease (IBD) patients undergoing medical treatment. The p rotocol employed included i.v. gadopentatate dimeglumine, pre- and pos t-contrast breath-hold Fast Low Angle Shot (FLASH), and fat-suppressed spin echo imaging. The percent contrast enhancement (% CE) of the fat -suppressed images was compared with severity of inflammation based on endoscopic and/or surgical findings. The % CE of the contrast-enhance d images was 169% +/- 63 in cases of severe inflammation (n = 16), 97% +/- 38 in moderate inflammation (n = 8), and 49% +/- 26 in mild infla mmation (n = 4). Significant correlations were found between the clini copathologic findings and (a) % CE, r = 0.74 (p = 0.0001); (b) length of affected bowel segment, r = 0.49 (p = 0.007); and (c) bowel wall th ickness, r = 0.42 (p = 0.02). In a subsequent comparison, % CE was cor related with length of affected bowel and bowel wall thickness. The be st correlation was bowel wall thickness, r = 0.53 (p < 0.004). Good co rrelation was found between MR findings and pathology/histology findin gs in the determination of bowel wall thickness, length of diseased bo wel, and severity of inflammation in 10 patients who underwent bowel r esection. The results of this study show that MR images demonstrate th e extent and severity of inflammatory changes in the GI tract, which c orrelate with endoscopic and histological findings.