Does a cleansing enema improve image quality of 3T surface coil multiparametric prostate MRI?

作者：Lim Christopher; Quon Jeff; McInnes Matt; Shabana Wael M; El Khodary Mohamed; Schieda Nicola^*

来源：Journal of Magnetic Resonance Imaging, 2015, 42(3): 689-697.

DOI：10.1002/jmri.24833

• prostate
• magnetic resonance imaging
• multiparametric
• diffusion weighted imaging
• dynamic contrast enhancement
• enema

PurposeTo assesses the utility of a preparatory enema in the interpretation of prostate multiparametric (MP) magnetic resonance imaging (MRI).
Materials and MethodsUnder a waiver from the Institutional Review Board (IRB), 32 patients without bowel preparation and 28 patients who underwent a self-administered enema were imaged consecutively with 3T MP-MRI over 6 months. Two blinded radiologists independently assessed image quality on T-2-weighted (T2W), trace b 1000 mm(2)/sec echo-planar (EPI) and apparent-diffusion coefficient (ADC) and assessed for motion/blur on T2W and distortion/blur on EPI and ADC. Radiologists also quantified rectal stool and gas. A third blinded radiologist generated contrast curves from dynamic contrast-enhanced (DCE) data at six locations and measured the number of corrupted data points, defined as >10% aberrant signal intensity change. Subjective scores were compared using Wilcoxon sign rank test. Rectal contents were correlated to artifact using Spearman correlation. Contrast curves were evaluated with independent t-tests.
ResultsThere was no difference in image quality on T2W (P=0.66-0.74), EPI (P=0.13-0.36) or ADC (P=0.49-0.59). There was less rectal stool in the enema group (P=0.004) and amount of stool correlated with motion artifact on T2W (r=0.23, P=0.02); however, there was no difference in motion artifact between groups (P=0.47-0.94). Only a minority of patients in the non-enema group had moderate or large amounts of stool (16%) and none of these patients had severe or extensive artifact on T-2. There was less rectal gas in the enema group (P=0.002); however, amount of gas did not correlate with distortion artifact on EPI or ADC (P=0.17-0.41) and there was no difference in blur (P=0.41-0.91) or distortion (P=0.31-0.99) on EPI or ADC between groups. There was no difference in corrupted data points on DCE (P=0.46).
ConclusionIn this study the use of a preparatory enema did not improve image quality or reduce artifact in prostate MP-MRI. J. Magn. Reson. Imaging 2015;42:689-697.

• 出版日期2015-9