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Contrast-Enhanced MRI Could Aid in Diagnosis of IC

Towner RA, Wisniewski AB, Wu DH, Van Gordon SB, Smith N, North JC, McElhaney R, Aston CE, Shobeiri SA, Kropp BP, Greenwood-Van Meerveld B, Hurst RE. A Feasibility Study to Determine whether Clinical Contrast-Enhanced MRI can Detect Increased Bladder Permeability in Patients with Interstitial Cystitis. J Urol. 2015 Aug 22. pii: S0022-5347(15)04676-5. doi: 10.1016/j.juro.2015.08.077. [Epub ahead of print]

Interstitial cystitis (IC) is difficult to diagnose because patients can have a wide range of symptoms, test results, and findings on physical examination. This study looked at the feasibility of applying contrast-enhanced magnetic resonance imaging (CE-MRI) to aid in diagnosis. Previous studies have suggested that CE-MRI might be useful for monitoring permeability of the bladder lining (some researchers have suggested that IC symptoms may stem from increased permeability of the bladder to urine solutes, or the substances dissolved in urine). To test CE-MRI in this setting, the researchers enrolled a small group of patients and measured the signal intensity (brightness) of the MRI in these patients and in control subjects. In the IC patients, they found a significant increase in signal intensity in regions at the front of the bladder as compared with the back of the bladder. Compared with control subjects, the patients with IC had a significantly increased signal intensity in front regions of the bladder compared with healthy control bladders. Other technical MRI measures, known as kurtosis and skewness, also were significantly different for the IC group versus the control group. These findings suggest that CE-MRI could provide a way to measure bladder permeability, which could help in diagnosis, stratifying levels of bladder pain, and monitor the effectiveness of therapy.