Micro-enema immediately prior to prostate MRI: effects on rectal gas, image quality and PI-QUAL score

• Published in: Abdominal radiology (New York) 2024-10
• Main Authors: Palmer, Jacob, Winata, Leon, Seale, Melanie, Sutherland, Tom, Page, Mark
• Format: Article
• Language: English
• ISSN: 2366-0058; 2366-0058
• DOI: 10.1007/s00261-024-04617-w

Our aim was to determine whether the administration of a micro-enema immediately prior to prostate MRI is associated with a reduction in rectal gas, gas related artifacts and an improvement in image quality and PI-QUAL score. This retrospective analysis enrolled 171 patients who underwent multiparametric 3T prostate MRI at our institution between January 2021 and September 2022. 86 patients received a micro-enema, and a further 85 patients did not. Two fellowship trained abdominal radiologists were blinded and independently reviewed each prostate MRI, recording scores on a dedicated scoring sheet. The quality of T2 weighted (T2W), diffusion weighted (DWI), and dynamic contrast enhancement (DCE) images were assessed according to standardised scales supported in the literature. In addition, gas related artifacts and rectal gas level were examined. An independent-samples Mann-Whitney U and t-test were performed, comparing both the median and mean score between micro-enema and no micro-enema groups for each reader. Spearman's correlation was used to determine the strength of relationship between variables. A quadratic weighted Cohen's Kappa and percent agreement were used to assess inter-observer agreement. Image quality was improved in those who received the micro-enema compared to those who did not according to the visual grading scale on the DWI sequence for both readers (reader 1: median 4 vs. 4, p