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

Updated: Feb 23, 2019
  • Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

The usefulness in transmural assessment, the capability for sagittal imaging, and the lack of invasiveness are attractive features of MRI.

In a study by Shoenut and associates, MRI was comparable to endoscopy in differentiating ulcerative colitis from Crohn disease and in assessing the severity of disease. [24] In 17 of 18 patients, a correct diagnosis was made using gadolinium-enhanced, fat-suppressed, T1-weighted, spin-echo MRI. In 15 patients, a correct diagnosis was made on endoscopy. Overall, MRI was not significantly better than endoscopy in distinguishing ulcerative colitis from Crohn disease. MRI permitted correct grading of the severity of inflammatory changes in 13 of 20 patients; endoscopy did so in 11 cases. MRI and endoscopic findings were each found to be within one grade of the histologic findings in 7 patients. No significant difference was found between MRI and endoscopy in terms of the estimation of disease severity (as determined from biopsy samples). Assessments of bowel wall thickness on MRIs correlated well with the percentage of contrast enhancement. [24]


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