The use of H-1 magnetic resonance spectroscopy in inflammatory bowel diseases: Distinguishing ulcerative colitis from Crohn's disease

OBJECTIVES: The distinction between the two major forms of inflammatory bow el diseases (IBD), i.e., ulcerative colitis (UC) and Crohn's disease is som etimes difficult and may lead to a diagnosis of indeterminate colitis. We h ave used H-1 magnetic resonance spectroscopy (MRS) combined with multivaria te methods of spectral data analysis to differentiate UC from Crohn's disea se and to evaluate normal-appearing mucosa in IBD. METHODS: Colon mucosal biopsies (45 UC and 31 Crohn's disease) were submitt ed to 1H MRS, and multivariate analysis was applied to distinguish the two diseases. A second study was performed to test endoscopically and histologi cally normal biopsies from IBD patients. A classifier was developed by trai ning on 101 spectra (76 inflamed IBD tissues and 25 normal control tissues) . The spectra of 38 biopsies obtained from endoscopically and histologicall y normal areas of the colons of patients with IBD were put into the validat ion test set. RESULTS: The classification accuracy between UC and Crohn's disease was 98. 6%, with only one case of Crohn's disease and no cases of UC misclassified. The diagnostic spectral regions identified by our algorithm included those for taurine, lysine, and lipid. In the second study, the classification ac curacy between normal controls and IBD was 97.9%. Only 47.4% of the endosco pically and histologically normal IBD tissue spectra were classified as tru e normals; 34.2% showed "abnormal" magnetic resonance spectral profiles, an d the remaining 18.4% could not be classified unambiguously. CONCLUSIONS: There is a strong potential for MRS to be used in the accurate diagnosis of indeterminate colitis; it may also be sensitive in detecting preclinical inflammatory changes in the colon. (C) 2001 by Am. Cell. of Gas troenterology.