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In this single-center study, consecutive patients in each arm with either enema or catheter preparation were retrospectively included. Two blinded readers independently assessed aspects of image quality on 5-point Likert scales. Scores were compared between groups and the influence of confounding factors evaluated using multivariable logistic regression. Prostate diameters were compared on DWI and T 2 -weighted imaging using intraclass correlation coefficients. Image quality was significantly higher in the enema group regarding the severity of susceptibility-related artifacts reader 1: 0.
Furthermore, there were significantly fewer substantial image distortions, with odds ratios of 0. Enema preparation is superior to catheter preparation and yields substantial improvements in image quality. Multi-parametric MRI mpMRI of the prostate is increasingly gaining importance for the diagnosis and staging of prostate cancer. Beyond that, the addition of DWI helps considerably in discerning malignant nodules in the transition zone [ 2 ]. Prostate MRI has been well established at both 1.
It has been shown that these artifacts may be mitigated by the application of reduced field-of-view FOV approaches such as inner-volume excitation but residual image distortions may still be observed [ 6 β 10 ]. The administration of a preparatory enema in the hours prior to the exam may reduce susceptibility-related artifacts. At the same time, enema preparation may promote peristalsis, amplifying motion-related artifacts [ 2 ]. Several studies have investigated the impact of preparatory enemas on image quality of DWI but with conflicting results [ 11 β 13 ].
In addition, enema preparation has not been compared with other methods of patient preparation. Thus, further studies are needed to evaluate the value of enema preparation, in particular relative to other methods. Due to the retrospective nature of the study, informed consent was waived. All consecutive patients undergoing mpMRI of the prostate at our institution between 1 January and 15 July were included.
