Value of high-field magnetic resonance imaging for diagnosis and classification of acute colonic diverticulitis

Abstract

Objectives: Due to limited and outdated literature, the role of magnetic resonance imaging (MRI) in the diagnostic work-up of acute colonic diverticulitis (ACD) is still under debate. The purpose of this study was to compare the performance of modern high-field MRI and multidetector computed tomography (MDCT) in the diagnosis and classification of ACD.

Methods: In our prospective study 24 emergency patients with the clinical diagnosis of ACD received MDCT and high-field MRI. Imaging features of ACD were assessed and categorized according to the classification of diverticular disease (CDD) by three independent readers. Results were matched with the final clinical report.

Results: MRI with a specialized examination protocol clearly depicted all relevant findings of ACD. Statistical analysis resulted in an almost perfect strength of agreement between CT and MRI across all readers for the final CDD category (κ = 0.94) and the stage-related image features (κ = 0.98). Moderate agreement was seen for the detection of micro-abscesses (κ = 0.78), with a slight advantage for MRI.

Conclusion: Modern high-field MRI is fully comparable to MDCT in the assessment of ACD and has the potential to serve as a first-line imaging tool.

Keywords: Classification; Diverticulitis; Magnetic resonance imaging; Multidetector computed tomography.