What is the role of MRI in the diagnosis of ulcerative colitis (UC)?

Updated: Apr 23, 2019
  • Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR; Chief Editor: Eugene C Lin, MD  more...
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Magnetic resonance cholangiopancreatography (MRCP) seems to be a reliable, noninvasive imaging method for diagnosing and following up primary sclerosing cholangitis. The rapid acquisition with relaxation enhancement (RARE) sequence has been found to have the highest diagnostic accuracy of the T2-weighted sequences.

Giovagnoni and associates used high-resolution MRI to study 16 resected rectosigmoid specimens of patients who underwent total colectomy in treatment of severe ulcerative colitis, [24] and the findings suggested that MRI can detect changes of the colon wall in ulcerative colitis. The in vitro results showed that MRI could depict all layers of the colonic wall. In ulcerative colitis specimens, in particular, T1-weighted spin-echo MRI showed thickening and the peculiar abnormal hyperintensity of the mucosal and submucosal layers. The in vivo results confirmed the high signal intensity of the mucosal and submucosal layers.

Gadolinium-based contrast agents have been linked to the development of nephrogenic systemic fibrosis (NSF) or nephrogenic fibrosing dermopathy (NFD). NSF/NFD is a debilitating and sometimes fatal disease. Characteristics include red or dark patches on the skin; burning, itching, swelling, hardening, and tightening of the skin; yellow spots on the whites of the eyes; joint stiffness with trouble moving or straightening the arms, hands, legs, or feet; pain deep in the hip bones or ribs; and muscle weakness. [11, 9]

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