Schreyer AG et al. (2005) Dark lumen magnetic resonance enteroclysis in combination with MRI colonography for whole bowel assessment in patients with Crohn's disease: first clinical experience. Inflamm Bowel Dis 11: 388–394

According to Schreyer et al., MRI enteroclysis (MRE) in combination with magnetic resonance imaging colonography (MRC) might be a promising new diagnostic approach for whole bowel assessment in patients with Crohn's disease.

In this study, 30 patients with known Crohn's disease were examined by applying the dark-lumen technique in the small bowel together with a combination of MRC and MRE in the unprepared colon. T2-weighted and contrast-enhanced T1-weighted sequences were acquired and image analysis was performed. Distension of the bowel and colon subdivided into different segments was assessed and graded. Colonic inflammation assessment was compared with conventional colonoscopy in 29 of the 30 patients.

All 30 MRI examinations had sufficient diagnostic quality, with the best distension found in the terminal ileum and the worst in the jejunum. Using complete conventional colonoscopy, a sensitivity of 55.1% with a specificity of 98.2% was achieved for correct inflammation grading in all segments. By analyzing the subgroup of inflamed colonic segments independently, however, the MRC-based method detected inflammation with an increased sensitivity of 70.2% and a specificity of 99.2%.

The authors conclude that using the dark-lumen approach together with integrative MRE and MRC slightly improves sensitivity, which in turn could improve the diagnostic value of abdominal MRI evaluation in Crohn's disease. Although MRC cannot replace conventional colonoscopy, it is able to detect extensively inflamed bowel segments with high specificity as a follow-up examination.