Colon diseases: MR evaluation using combined T2-weighted single-shot echo train spin-echo and gadolinium-enhanced spoiled gradient-echo sequences.

Abstract

This study demonstrates the appearance of large bowel diseases on magnetic resonance (MR) images using breath-hold T2-weighted half-Fourier acquisition snapshot turbo spin-echo (HASTE), breath-hold T1-weighted spoiled gradient-echo (SGE), and breath-hold gadolinium-enhanced T1-weighted SGE with and without fat-suppression sequences. The study represents a collective experience using a generalized combined abdominal-pelvic imaging protocol. Of 29 patients, 27 had surgical, endoscopic, microbiological, and/or histopathological correlation, and 2 had a diagnosis based on characteristic imaging findings. Fifteen patients had neoplastic disease including colon adenocarcinoma (n = 11), rectosigmoid carcinoid (n = 1), familial adenomatous polyposis (n = 2), and cecal lipoma (n = 1). Fourteen patients had non-neoplastic disease including diverticulosis (n = 6), ischemic colitis (n = 2), pseudomembranous colitis (n = 2), acute appendicitis with periappendiceal abscess (n = 2), Mycobacterium avium intracellulare (MAI) colitis (n = 1), and Crohn's proctocolitis (n = 1). In all 15 patients with neoplastic diseases, MR imaging depicted the primary lesions and demonstrated local extent. Mass lesions were best shown on T2-weighted HASTE and gadolinium-enhanced fat-suppressed SGE images. Of 14 patients with non-neoplastic diseases, inflammatory changes were best shown on gadolinium-enhanced fat-suppressed T1-weighted SGE images in all cases. MR imaging with fast scanning breath-hold techniques and intravenous gadolinium enhancement provided good depiction and characterization of large bowel diseases.