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Ihara R, Oura D, Ichimura W, Kobayashi K. Magnetic resonance cholangiopancreatography using T2 preparation pulse: quantitative and qualitative analyses. Acta Radiol 2023; 64:2969-2976. [PMID: 37807657 DOI: 10.1177/02841851231203055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
BACKGROUND Magnetic resonance cholangiopancreatography (MRCP) may exhibit ghosting and blurring artifacts due to irregular breathing cycles, which can be overcome by shortening the shot duration. T2 preparation pulse enables heavy T2 contrast even with a shorter TE by use of the shortened shot duration; therefore, a technique using T2 preparation pulse combined with 3D turbo spin-echo MRCP (TPT-MRCP) was constructed. PURPOSE To evaluate the clinical usefulness of TPT-MRCP in both navigation and breath-hold sequences compared to the conventional method. MATERIAL AND METHODS We obtained navigation MRCP, which were TPT and conventional 3D turbo spin-echo in 37 patients, and breath-hold MRCP in 31 patients, which were TPT and gradient and spin echo. The quantitative evaluation included signal-to-noise ratio, contrast ratio, contrast-to-noise ratio and sharpness of the common bile duct in all sequences. Two radiologists visually evaluated image quality using a five-point grading method, assessing overall image quality and each of the six areas: common bile duct, right hepatic duct, left hepatic duct, main pancreatic duct, cystic duct and motion artifact. RESULTS TPT-MRCP was significantly superior to conventional MRCP in all quantitative evaluations, except for signal-to-noise ratio in the navigation sequence. In the visual evaluation, TPT-MRCP provided higher image quality than the conventional technique in nearly all areas. The kappa (k) coefficient of the overall image quality was good for all sequences (κ = 0.61-0.8). CONCLUSION TPT-MRCP provides higher image quality than conventional techniques in both navigation and breath-hold sequences. The present study demonstrates the greater clinical usefulness of TPT-MRCP.
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Affiliation(s)
- Riku Ihara
- Department of radiology, Otaru General Hospital, Otaru, Japan
| | - Daisuke Oura
- Department of radiology, Otaru General Hospital, Otaru, Japan
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Wataru Ichimura
- Department of radiology, Otaru General Hospital, Otaru, Japan
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Che X, Yang C, Pan L, Gu D, Dai G, Shu J, Yang L. Achieving safe and high-performance gastrointestinal tract spectral CT imaging with small-molecule lanthanide complex. Biomater Res 2023; 27:119. [PMID: 37990349 PMCID: PMC10664581 DOI: 10.1186/s40824-023-00463-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Non-intrusive imaging of gastrointestinal (GI) tract using computed tomography (CT) contrast agents is of the most significant issues in the diagnosis and treatment of GI diseases. Moreover, spectral CT, which can generate monochromatic images to display the X-ray attenuation characteristics of contrast agents, provides a better imaging sensitivity for diagnose inflammatory bowel disease (IBD) than convention CT imaging. METHODS Herein, a convenient and one-pot synthesis method is provided for the fabrication of small-molecule lanthanide complex Holmium-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid (Ho-DOTA) as a biosafe and high-performance spectral CT contrast agent for GI imaging with IBD. In vivo CT imaging was administered with both healthy mice and colitis mice induced by dextran sodium sulfate. RESULTS We found that Ho-DOTA accumulated in inflammation sites of large intestines and produced high CT contrast compared with healthy mice. Both in vitro and in vivo experimental results also showed that Ho-DOTA provided much more diagnostic sensitivity and accuracy due to the excellent X-ray attenuation characteristics of Ho-DOTA compared with clinical iodinate agent. Furthermore, the proposed contrast media could be timely excreted from the body via the urinary and digestive system, keeping away from the potential side effects due to long-term retention in vivo. CONCLUSION Accordingly, Ho-DOTA with excellent biocompatibility can be useful as a potential high-performance spectral CT contrast agent for further clinical imaging of gastrointestinal tract and diagnosis of intestinal system diseases.
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Affiliation(s)
- Xiaoling Che
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China
| | - Chunmei Yang
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China
| | - Liping Pan
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China
| | - Didi Gu
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China
| | - Guidong Dai
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China
| | - Jian Shu
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China.
| | - Lu Yang
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China.
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Performance of a new natural oral contrast agent (LumiVision®) in dynamic MR swallowing. Eur Radiol 2021; 31:8578-8585. [PMID: 33893856 PMCID: PMC8523424 DOI: 10.1007/s00330-021-07927-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 02/17/2021] [Accepted: 03/23/2021] [Indexed: 11/24/2022]
Abstract
Objectives To evaluate image quality by first use of LumiVision® in dynamic MR swallowing, a contrast medium consisting of biological substances versus a gadolinium-buttermilk mixture in patients who underwent Nissen fundoplication due to gastroesophageal reflux disease (GERD). Methods The protocol of this retrospective study was approved by the local Institutional Review Board. A hundred twenty-nine patients (146 examinations) underwent a dynamic MR swallowing study (at 1.5 T or 3.0 T) and received an oral contrast agent. Two readers evaluated the distention of the esophagus, contrast, and traceability of the bolus in a 3-point scale. A steady-state coherent sequence (B-FFE, TrueFISP) was used. The patients were divided into 3 different groups: 53 patients received gadolinium chelate (Dotarem®)–buttermilk mixture (GBM) in a dilution of 1:40 as an oral contrast agent; 44 patients received LumiVision® water mixture (LWM) in a dilution of 1:1 and 49 patients received LumiVision® (L) undiluted. Results GBM showed significantly better results in overall evaluation for both readers in contrast to LWM (p = .003, p = .002). L also reached significantly better results in overall evaluation than LWM in both readers (p = .004, p = .042). There was no significant difference in the overall evaluation between L and GBM (p = .914, p = .376).According to Landis and Koch, interobserver agreement was “substantial” (Cohen’s kappa = 0.738) between both readers. Conclusion LumiVision® undiluted showed equal image quality compared to gadolinium-buttermilk mixture. The constellation of LumiVision® water mixture led to a clearly negative result in relation to the image quality compared to LumiVision® undiluted. Therefore, oral ingestion of LumiVision® undiluted is recommended for MR swallowing examinations. Key Points • LumiVision® undiluted shows significantly better image quality in comparison to LumiVision® diluted in oral application in swallowing MRI. • LumiVision® undiluted shows equal image quality in comparison to gadolinium-buttermilk mixture in oral application. • Oral ingestion of LumiVision® undiluted can replace gadolinium-buttermilk mixture in oral MR examinations.
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Origin of the MRI Contrast in Natural and Hydrogel Formulation of Pineapple Juice. Bioinorg Chem Appl 2021; 2021:6666018. [PMID: 33488688 PMCID: PMC7803405 DOI: 10.1155/2021/6666018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/30/2020] [Indexed: 02/07/2023] Open
Abstract
Magnetic resonance imaging (MRI) often requires contrast agents to improve the visualization in some tissues and organs, including the gastrointestinal tract. In this latter case, instead of intravascular administration, oral agents can be used. Natural oral contrast agents, such as fruit juice, have the advantages of better taste, tolerability, and lower price with respect to the artificial agents. We have characterized the relaxometry profiles of pineapple juice in order to understand the origin of the increase in relaxation rates (and thus of the MRI contrast) in reference to its content of manganese ions. Furthermore, we have characterized the relaxometry profiles of pineapple juice in the presence of alginate in different amounts; the interaction of the manganese ions with alginate slows down their reorientation time to some extent, with a subsequent increase in the relaxation rates. The relaxometry profiles were also compared with those of manganese(II) solutions in 50 mmol/dm3 sodium acetate solution (same pH of pineapple juice), which revealed sizable differences, mostly in the number of water molecules coordinated to the metal ion, their lifetimes, and in the constant of the Fermi-contact interaction. Finally, the fit of the transverse relaxivity shows that the increased viscosity in the hydrogel formulations can improve significantly the negative contrast of pineapple juice at the magnetic fields relevant for clinical MRI.
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Chien CP, Chiu FM, Shen YC, Chen YH, Chung HW. Magnetic resonance cholangiopancreatography at 3T in a single breath-hold: comparative effectiveness between three-dimensional (3D) gradient- and spin-echo and two-dimensional (2D) thick-slab fast spin-echo acquisitions. Quant Imaging Med Surg 2020; 10:1265-1274. [PMID: 32550135 DOI: 10.21037/qims.2020.04.14] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background To compare the depiction conspicuity of three-dimensional (3D) magnetic resonance cholangiopancreatography (MRCP) based on gradient- and spin-echo (GRASE) and two-dimensional (2D) thick-slab MRCP using fast spin-echo (FSE) in different segments of hepatic and pancreatic ducts at 3T. Methods Both 3D GRASE and 2D thick-slab FSE MRCP, with parameters adjusted under the constraints of specific absorption rate and scan time within single breath-hold, were performed for 95 subjects (M/F =49:46; age range, 25-75) at 3T. Conspicuity of eight ductal segments was graded by two experienced raters using a 4-point score. Situations where one technique is superior or inferior to the other were recorded. Results 3D GRASE MRCP outperformed 2D thick-slab FSE MRCP in the common bile duct and common hepatic ducts (both with P<0.001), but compared inferiorly in the right hepatic ducts (P<0.001), right posterior hepatic ducts (P<0.005) and pancreatic duct distal (P<0.05). Performing both 3D and 2D MRCP would reduce the number of non-diagnostic readings in the left hepatic duct to 10 remaining (5.3%), compared with 31 (16.3%) or 21 (11.1%) out of 190 readings if using 3D GRASE or 2D thick-slab FSE alone, respectively. Conclusions Although 3D GRASE MRCP is preferential to visualize the common bile duct and common hepatic duct within one single breath-hold, the complementary role of 2D thick-slab FSE MRCP in smaller hepatic and pancreatic ducts makes it a useful adjunct if performed additionally.
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Affiliation(s)
- Cheng-Ping Chien
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei 10617.,Taipei Beitou Health Management Hospital, Taipei 11252
| | | | - Yen-Chun Shen
- Taipei Beitou Health Management Hospital, Taipei 11252
| | - Yi-Hsun Chen
- Taipei Beitou Health Management Hospital, Taipei 11252
| | - Hsiao-Wen Chung
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei 10617
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Grimm M, Ball K, Scholz E, Schneider F, Sivert A, Benameur H, Kromrey ML, Kühn JP, Weitschies W. Characterization of the gastrointestinal transit and disintegration behavior of floating and sinking acid-resistant capsules using a novel MRI labeling technique. Eur J Pharm Sci 2019; 129:163-172. [DOI: 10.1016/j.ejps.2019.01.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 12/03/2018] [Accepted: 01/09/2019] [Indexed: 01/01/2023]
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Yang X, Lovell JF, Zhang Y. Ingestible Contrast Agents for Gastrointestinal Imaging. Chembiochem 2019; 20:462-473. [PMID: 30421487 DOI: 10.1002/cbic.201800589] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Indexed: 12/17/2022]
Abstract
Gastrointestinal (GI) ailments cover a wide variety of diseases involving the esophagus, stomach, small intestine, large intestine, and rectum. They bring about many inconveniences in daily life in chronic diseases and can even be life threatening in acute cases. Rapid and safe detection approaches are essential for early diagnosis and timely management. Contrast agents for GI imaging can enhance contrast to distinguish abnormal lesions from normal structures. Computed tomography and magnetic resonance imaging are two important diagnostic tools for the evaluation of GI conditions. This review mainly involves several common GI diseases, including inflammatory diseases, intestinal tumors, diarrhea, constipation, and gastroesophageal reflux diseases. Selected contrast agents, such as barium sulfate, iodine-based agents, gadolinium-based agents, and others, are summarized. Going forward, continued endeavors are being made to develop more emerging contrast agents for other imaging modalities.
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Affiliation(s)
- Xingyue Yang
- School of Chemical Engineering and Technology, Tianjin University, Tianjin, 301636, China
| | - Jonathan F Lovell
- Department of Biomedical Engineering, State University of New York at Buffalo, Buffalo, NY, 14260, USA
| | - Yumiao Zhang
- School of Chemical Engineering and Technology, Tianjin University, Tianjin, 301636, China
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What is the best fruit juice to use as a negative oral contrast agent in magnetic resonance cholangiopancreatography? Clin Radiol 2018; 74:220-227. [PMID: 30554806 DOI: 10.1016/j.crad.2018.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 11/19/2018] [Indexed: 02/06/2023]
Abstract
AIM To identify, in vitro, the best fruit juice to use as oral contrast agent in magnetic resonance cholangiopancreatography (MRCP) and to test, in vivo, the best natural juice and the new parameters in MRCP sequences identified in vitro. MATERIALS AND METHODS The in vitro evaluations consisted of measuring the T2 values of a pure solution of manganese (Mn) and iron (Fe) at different concentrations, measuring the content of Mn and Fe in five commercial juices and their T2 relaxation times, and identifying the optimal juice dilution for suppressing the gastrointestinal fluid signal. The new parameters of MRCP sequences were tested in vivo. RESULTS Manganese alone strongly influenced the shortening of the T2 values (p=0.004). The T2 value with an echo time (TE) of ≥1,000 ms enabled sufficient intestinal fluid suppression in the case of high juice dilution. A flip angle of 90° maximised the differences between the high signal from static fluids, such as the bile and the fluid in the gastrointestinal tract, using fast imaging employing steady-state acquisition (FIESTA) sequences (p<0.001). CONCLUSION The shortening of the T2 relaxation time depended only on the Mn concentration. All the commercial juices had an Mn concentration sufficient to suppress the gastrointestinal fluid signal using long TE sequences. The oral ingestion of commercial juice before MRCP was enough to suppress the signal from the gastrointestinal fluids, regardless of its dilution after ingestion. When using FIESTA sequences, a flip angle of 90° allowed the best suppression of gastrointestinal fluid signals.
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Faletti R, Gatti M, Di Chio A, Fronda M, Anselmino M, Ferraris F, Gaita F, Fonio P. Concentrated pineapple juice for visualisation of the oesophagus during magnetic resonance angiography before atrial fibrillation radiofrequency catheter ablation. Eur Radiol Exp 2018; 2:39. [PMID: 30460417 PMCID: PMC6246758 DOI: 10.1186/s41747-018-0067-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 10/09/2018] [Indexed: 11/10/2022] Open
Abstract
The purpose of this study was to compare in vitro pineapple juice and a solution of concentrated pineapple juice with a paramagnetic contrast agent in order to determine the feasibility of using the solution of concentrated pineapple juice in vivo for oesophagus visualisation at magnetic resonance angiography (MRA) before the radiofrequency catheter ablation procedure for atrial fibrillation. The pineapple juice was concentrated by a microwave heating evaporation process performed in a domestic microwave oven. Five grams of modified potato starch for every 40 mL of concentrated pineapple juice were added to the concentrated pineapple juice in order to thicken the solution. The solution resulted visually and quantitatively as hyperintense as the contrast agent in vitro (ratio = 1.02). in vivo, no technical difficulties were encountered during the MRA acquisition and a complete enhanced oesophagus was obtained in 37/38 patients (97.4%). The volumetric analysis and the three-dimensional reconstruction were feasible; the quality was rated as diagnostic in every patient. The intensified oesophagus was successfully merged into the electro-anatomical maps in all the patients. In summary, we demonstrated that this technique allows a feasible and safe oesophagus visualisation during MRA.
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Affiliation(s)
- Riccardo Faletti
- Radiology Unit, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Marco Gatti
- Radiology Unit, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126, Turin, Italy.
| | - Andrea Di Chio
- Radiology Unit, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Marco Fronda
- Radiology Unit, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Matteo Anselmino
- Division of Cardiology, Department of Medical Sciences, "Città della Salute e della Scienza" Hospital, University of Turin, Turin, Italy
| | - Federico Ferraris
- Division of Cardiology, Department of Medical Sciences, "Città della Salute e della Scienza" Hospital, University of Turin, Turin, Italy
| | - Fiorenzo Gaita
- Division of Cardiology, Department of Medical Sciences, "Città della Salute e della Scienza" Hospital, University of Turin, Turin, Italy
| | - Paolo Fonio
- Radiology Unit, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126, Turin, Italy
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Arthurs OJ, Graves MJ, Edwards AD, Joubert I, Set PAK, Lomas DJ. Interactive neonatal gastrointestinal magnetic resonance imaging using fruit juice as an oral contrast media. BMC Med Imaging 2014; 14:33. [PMID: 25245815 PMCID: PMC4186814 DOI: 10.1186/1471-2342-14-33] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 08/21/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective was to evaluate the use of fruit juice with an interactive inversion recovery (IR) MR pulse sequence to visualise the gastrointestinal tract. METHODS We investigated the relaxation properties of 12 different natural fruit juices in vitro, to identify which could be used as oral contrast. We then describe our initial experience using an interactive MR pulse sequence to allow optimal visualisation after administering pineapple juice orally, and suppressing pre-existing bowel fluid contents, with variable TI in three adult and one child volunteer. RESULTS Pineapple juice (PJ) had both the shortest T1 (243 ms) and shortest T2 (48 ms) of the fruit juices tested. Optimal signal differentiation between pre-existing bowel contents and oral PJ administration was obtained with TIs of between 900 and 1100 ms. CONCLUSION The use of an inversion recovery preparation allowed long T1 pre-existing bowel contents to be suppressed whilst the short T1 of fruit juice acts as a positive contrast medium. Pineapple juice could be used as oral contrast agent for neonatal gastrointestinal magnetic resonance imaging.
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Affiliation(s)
- Owen J Arthurs
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.
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Duarte JA, Furtado APA, Marroni CA. Use of pineapple juice with gadopentetate dimeglumine as a negative oral contrast for magnetic resonance cholangiopancreatography: a multicentric study. ACTA ACUST UNITED AC 2012; 37:447-56. [PMID: 21630051 DOI: 10.1007/s00261-011-9761-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We evaluated the efficacy of pineapple juice with gadopentetate dimeglumine as a negative oral contrast agent for magnetic resonance cholangiopancreatography (MRCP). Images were obtained before and after the intake of a negative oral contrast agent. Images obtained from six different areas of the biliary tree were analyzed by three different radiologists, who were blind to the exams; scores regarding image quality were given to each area. The statistical analysis showed a significant difference between images before and after the use of the contrast agent (P < 0.001) for the three radiologists (R1-R3). Mean scores given by radiologists before the intake of the contrast agent were 2.49 ± 0.42 (R1), 2.62 ± 0.32 (R2), and 2.22 ± 0.46 (R3). After the intake, mean scores were 3.38 ± 0.62 (R1), 3.48 ± 0.55 (R2), and 2.89 ± 0.69 (R3). The ducts that showed the highest scores were the common bile duct and duct of Wirsung, the distal portion of the common bile duct and the cystic duct. We suggest herein that the contrast agent pineapple juice with gadopentate dimeglumine constitutes an efficient negative oral contrast agent for MRCP, for it efficiently eliminates the signal of the digestive tube in MRCP images.
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Affiliation(s)
- Juliana Avila Duarte
- Radiologia - Magnetic Resonance, Hospital de Clínicas de Porto Alegre, RS, Brazil.
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