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

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  • 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 T2‐weighted (T2W), trace b 1000 mm2/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 T2. 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.


  • El-Khodary, Mohamed
  • Lim, Christopher
  • Quon, Jeff
  • McInnes, Matt
  • Shabana, Wael M
  • El‐Khodary, Mohamed
  • Schieda, Nicola

publication date

  • September 2015

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