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Licciardi G, Rizzo D, Ravera E, Fragai M, Parigi G, Luchinat C. Not only manganese, but fruit component effects dictate the efficiency of fruit juice as an oral magnetic resonance imaging contrast agent. NMR IN BIOMEDICINE 2022; 35:e4623. [PMID: 34595785 PMCID: PMC9285043 DOI: 10.1002/nbm.4623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/20/2021] [Accepted: 09/01/2021] [Indexed: 06/13/2023]
Abstract
Several fruit juices are used as oral contrast agents to improve the quality of images in magnetic resonance cholangiopancreatography. They are often preferred to conventional synthetic contrast agents because of their very low cost, natural origin, intrinsic safety, and comparable image qualities. Pineapple and blueberry juices are the most employed in clinical practice due to their higher content of manganese(II) ions. The interest of pharmaceutical companies in these products is testified by the appearance in the market of fruit juice derivatives with improved contrast efficacy. Here, we investigate the origin of the contrast of blueberry juice, analyze the parameters that can effect it, and elucidate the differences with pineapple juice and manganese(II) solutions. It appears that, although manganese(II) is the paramagnetic ion responsible for the contrast, it is the interaction of manganese(II) with other juice components that modulates the efficiency of the juice as a magnetic resonance contrast agent. On these grounds, we conclude that blueberry juice concentrated to the same manganese concentration of pineapple juice would prove a more efficient contrast agent than pineapple juice.
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Affiliation(s)
- Giulia Licciardi
- Magnetic Resonance Center (CERM), Department of Chemistry “Ugo Schiff”University of FlorenceSesto FiorentinoItaly
- Consorzio Interuniversitario Risonanze Magnetiche Metallo Proteine (CIRMMP)Sesto FiorentinoItaly
| | - Domenico Rizzo
- Magnetic Resonance Center (CERM), Department of Chemistry “Ugo Schiff”University of FlorenceSesto FiorentinoItaly
- Consorzio Interuniversitario Risonanze Magnetiche Metallo Proteine (CIRMMP)Sesto FiorentinoItaly
| | - Enrico Ravera
- Magnetic Resonance Center (CERM), Department of Chemistry “Ugo Schiff”University of FlorenceSesto FiorentinoItaly
- Consorzio Interuniversitario Risonanze Magnetiche Metallo Proteine (CIRMMP)Sesto FiorentinoItaly
| | - Marco Fragai
- Magnetic Resonance Center (CERM), Department of Chemistry “Ugo Schiff”University of FlorenceSesto FiorentinoItaly
- Consorzio Interuniversitario Risonanze Magnetiche Metallo Proteine (CIRMMP)Sesto FiorentinoItaly
| | - Giacomo Parigi
- Magnetic Resonance Center (CERM), Department of Chemistry “Ugo Schiff”University of FlorenceSesto FiorentinoItaly
- Consorzio Interuniversitario Risonanze Magnetiche Metallo Proteine (CIRMMP)Sesto FiorentinoItaly
| | - Claudio Luchinat
- Magnetic Resonance Center (CERM), Department of Chemistry “Ugo Schiff”University of FlorenceSesto FiorentinoItaly
- Consorzio Interuniversitario Risonanze Magnetiche Metallo Proteine (CIRMMP)Sesto FiorentinoItaly
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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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Mohabir S, Pitcher RD, Perumal R, Goodier MDM. The efficacy of pineapple juice as a negative oral contrast agent in magnetic resonance cholangiopancreatography. SA J Radiol 2020; 24:1875. [PMID: 32832119 PMCID: PMC7433279 DOI: 10.4102/sajr.v24i1.1875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/13/2020] [Indexed: 11/03/2022] Open
Abstract
Background During magnetic resonance cholangiopancreatography (MRCP), the pancreatobiliary ducts can be obscured by the high-intensity signal from the stomach and duodenum. Pineapple juice may be an alternative to commercially available negative contrast agents, but has not been evaluated locally. Objectives To evaluate the efficacy of a local, off-the-shelf pineapple juice preparation as a negative oral contrast agent for MRCP. Method An observational, analytical study was conducted during January–December 2017. A 1.5 Tesla MRCP sequence was performed immediately before and after ingestion of 250 mL of a local, commercially-available pineapple juice preparation. Image evaluation was performed by two radiologists with independent, blind assessment of gastric/duodenal signal intensity and biliary /pancreatic duct visibility, before and after pineapple juice. Results Fifty adult patients (F = 44, 88%) with median age 44 years (IQR: 34.75, 57) were included. After pineapple juice administration, there was significant measured (1661.51 vs. 1409.94, p < 0.01) and perceived (2.16 vs. 2.72, p < 0.01) duodenal signal reduction but no significant change in measured (1081.17 vs. 1044.38, p = 0.34) or perceived (2.73 vs. 2.84, p = 0.14) gastric signal intensity. Visibility of the common bile duct was significantly improved (3.67 vs. 3.86, p < 0.01), whilst that of the main pancreatic duct showed no significant change (2.92 vs. 2.86, p = 0.44). Conclusion The local pineapple juice preparation used in this study is an effective, affordable and natural negative oral contrast agent for enhancement of MRCP images, and specifically improves visualisation of the common bile duct.
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Affiliation(s)
- Sheryl Mohabir
- Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Richard D Pitcher
- Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rubeshan Perumal
- Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
| | - Matthew D M Goodier
- Department of Radiology, Grey's Hospital Pietermaritzburg, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
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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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Khatri G, Coleman J, Leyendecker JR. Magnetic Resonance Enterography for Inflammatory and Noninflammatory Conditions of the Small Bowel. Radiol Clin North Am 2018; 56:671-689. [PMID: 30119767 DOI: 10.1016/j.rcl.2018.04.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Magnetic resonance enterography (MRE) is an effective noninvasive tool for evaluation of inflammatory and noninflammatory conditions of the small bowel. MRE allows for repeated evaluation of patients with Crohn disease without exposure to ionizing radiation, and can be used to assess disease status and direct management. MRE also allows evaluation of neoplastic and other nonneoplastic conditions of the small bowel. Adequate patient preparation and acquisition techniques are required for optimal image quality.
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Affiliation(s)
- Gaurav Khatri
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Jay Coleman
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - John R Leyendecker
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
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Wooten AL, Aweda TA, Lewis BC, Gross RB, Lapi SE. Biodistribution and PET Imaging of pharmacokinetics of manganese in mice using Manganese-52. PLoS One 2017; 12:e0174351. [PMID: 28306727 PMCID: PMC5357058 DOI: 10.1371/journal.pone.0174351] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 03/07/2017] [Indexed: 11/28/2022] Open
Abstract
Manganese is essential to life, and humans typically absorb sufficient quantities of this element from a normal healthy diet; however, chronic, elevated ingestion or inhalation of manganese can be neurotoxic, potentially leading to manganism. Although imaging of large amounts of accumulated Mn(II) is possible by MRI, quantitative measurement of the biodistribution of manganese, particularly at the trace level, can be challenging. In this study, we produced the positron-emitting radionuclide 52Mn (t1/2 = 5.6 d) by proton bombardment (Ep<15 MeV) of chromium metal, followed by solid-phase isolation by cation-exchange chromatography. An aqueous solution of [52Mn]MnCl2 was nebulized into a closed chamber with openings through which mice inhaled the aerosol, and a separate cohort of mice received intravenous (IV) injections of [52Mn]MnCl2. Ex vivo biodistribution was performed at 1 h and 1 d post-injection/inhalation (p.i.). In both trials, we observed uptake in lungs and thyroid at 1 d p.i. Manganese is known to cross the blood-brain barrier, as confirmed in our studies following IV injection (0.86%ID/g, 1 d p.i.) and following inhalation of aerosol, (0.31%ID/g, 1 d p.i.). Uptake in salivary gland and pancreas were observed at 1 d p.i. (0.5 and 0.8%ID/g), but to a much greater degree from IV injection (6.8 and 10%ID/g). In a separate study, mice received IV injection of an imaging dose of [52Mn]MnCl2, followed by in vivo imaging by positron emission tomography (PET) and ex vivo biodistribution. The results from this study supported many of the results from the biodistribution-only studies. In this work, we have confirmed results in the literature and contributed new results for the biodistribution of inhaled radiomanganese for several organs. Our results could serve as supporting information for environmental and occupational regulations, for designing PET studies utilizing 52Mn, and/or for predicting the biodistribution of manganese-based MR contrast agents.
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Affiliation(s)
- A. Lake Wooten
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Department of Biomedical Engineering, Washington University, St. Louis, United States of America
| | - Tolulope A. Aweda
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Benjamin C. Lewis
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Department of Physics, Washington University, St. Louis, United States of America
| | - Rebecca B. Gross
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Suzanne E. Lapi
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Department of Biomedical Engineering, Washington University, St. Louis, United States of America
- Department of Radiology, University of Alabama at Birmingham, Birmingham, United States of America
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Abstract
OBJECTIVE The purpose of this study was to compare the in vitro effects of date syrup with those of other contrast agents by qualitative and quantitative analysis and in vivo evaluation of the use of date syrup to improve the quality of MRCP images. MATERIALS AND METHODS Phantoms containing date syrup, ferumoxsil, pineapple juice, and water were imaged by 1.5-T MRI with T2-weighted and MRCP sequences, and signal-to-noise ratios were calculated. Biochemical analysis of date syrup was performed to find the nature of iron in it, and the iron content was quantified by energy-dispersive x-ray spectroscopy. Sixty patients underwent MRCP before and 30 minutes after ingestion of 100 mL of date syrup. Unenhanced and contrast-enhanced images were scored for gastrointestinal tract signal suppression and visualization of various pancreaticobiliary structures. RESULTS In vitro evaluation showed that images obtained with date syrup had a signal-to-noise ratio comparable to that of images obtained with ferumoxsil in T2-weighted and MRCP sequences. The iron concentration in date syrup was 2.6 mg/dL, and it was in ferric form. Images obtained after oral contrast administration had statistically significant improvement in gastrointestinal tract signal suppression (p < 0.001) and an increase in visibility of the common bile duct, cystic duct, and pancreatic duct (all p < 0.001). No adverse effects were noted in any of the patients. CONCLUSION Date syrup can be used as a negative oral contrast agent for gastrointestinal tract signal suppression during MRCP and for improving visualization of various pancreaticobiliary structures.
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A Comparison of Different Methods to Generate Tooth Surface Models Without Applying Ionizing Radiation for Digital 3-Dimensional Image Fusion With Magnetic Resonance Imaging–Based Data of the Head and Neck Region. J Comput Assist Tomogr 2015; 39:882-9. [PMID: 26295193 DOI: 10.1097/rct.0000000000000293] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Alshehri FMA. Comparative study of pineapple juice as a negative oral contrast agent in magnetic resonance cholangiopancreatography. J Clin Diagn Res 2015; 9:TC13-6. [PMID: 25738055 DOI: 10.7860/jcdr/2015/10240.5463] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 10/09/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The aim of this study was to compare the image quality of magnetic resonance Cholangiopancreatography (MRCP) using Pineapple Juice (PJ) or ranitidine as negative oral contrast agents and no agent. MATERIALS AND METHODS MRCP images of patients administered PJ (n = 117) or Ranitidine (n = 110) at random, and patients without an agent (n = 50) were evaluated. The subjective image quality of the overall, extra hepatic bile duct and pancreatic duct and the degree of elimination of gastrointestinal fluid were scored by two blinded radiologists. RESULTS were compared using Mann-Whitney's U-test. RESULTS The degrees of elimination of gastro duodenal fluid of PJ and ranitidine were significantly better than those without an agent (p < 0.01 and p < 0.01, respectively). The subjective image quality of PJ of the overall and extra hepatic bile duct were significantly better, although no significant differences for ranitidine were observed compared with those without an agent (p < 0.01 and p =0.23, p = 0.025 and p = 0.18). There were no significant differences for the pancreatic duct (p = 0.13 and p = 0.20), nor were there any significant differences in the evaluations between PJ and ranitidine (p = 0.21 and p = 0.96). CONCLUSION PJ showed better performance compared to that of conventional ranitidine in terms of pancreatic and biliary depiction and safety.
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Affiliation(s)
- Fahad Mohammed Ali Alshehri
- Vice Dean of Medical Affairs, Assistant Professor, Department of Diagnostic Radiology, College of Medicine, Qassim University , Saudi Arabia
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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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Bittman ME, Callahan MJ. The effective use of acai juice, blueberry juice and pineapple juice as negative contrast agents for magnetic resonance cholangiopancreatography in children. Pediatr Radiol 2014; 44:883-7. [PMID: 24573534 DOI: 10.1007/s00247-014-2884-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 12/16/2013] [Accepted: 01/16/2014] [Indexed: 11/26/2022]
Abstract
Magnetic resonance cholangiopancreatography (MRCP) is commonly performed in the evaluation of known or suspected pancreaticobiliary disease in children. The administration of a negative oral contrast agent can improve the quality of the examination without significant additional cost. We describe our experience with certain brands of acai juice, blueberry juice and pineapple juice as negative oral contrast agents in children. We believe these fruit juices are safe, palatable and may improve MRCP image quality.
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Affiliation(s)
- Mark E Bittman
- Department of Radiology, Cohen Children's Medical Center of New York, North Shore Long Island Jewish Health System, 270-05 76th Ave., New Hyde Park, NY, 11040, USA,
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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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Kueny-Stotz M, Garofalo A, Felder-Flesch D. Manganese-Enhanced MRI Contrast Agents: From Small Chelates to Nanosized Hybrids. Eur J Inorg Chem 2012. [DOI: 10.1002/ejic.201101163] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Ng IW, Ono T, Inoue-Arai MS, Honda E, Kurabayashi T, Moriyama K. Application of MRI movie for observation of articulatory movement during a fricative /s/ and a plosive /t/. Angle Orthod 2011; 81:237-44. [PMID: 21208075 DOI: 10.2319/060210-301.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To use an accurate method of tooth visualization in magnetic resonance imaging (MRI) movie for the observation of spatio-temporal relationships among articulators. MATERIALS AND METHODS The subjects were two volunteers. Each subject repeated a vowel-consonant-vowel syllable (ie, /asa/; /ata/), and the run was measured using a gradient echo sequence. A custom-made clear retainer filled with the jelly form of ferric ammonium citrate was then fit onto the dental arch, and a T1-weighted turbo-spin-echo sequence was taken. Landmarks were used for superimposition of the incisor boundary onto sequential images of MRI movie. Tracings were conducted to observe the spatio-temporal relationships among articulators. RESULTS The incisor boundary was clearly visible in the magnetic resonance images. After superimposition, the contact distance of the tongue to palate/incisor was found to be longer during /t/-articulation than during /s/-articulation. There were prominent differences in images with and without tooth superimposition in the front oral cavity. CONCLUSIONS The method could distinctly extract a tooth boundary in MRI. Detailed configurational relationships between the tongue and tooth were observed during the production of a fricative and a plosive in MRI movie using this method.
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Affiliation(s)
- I W Ng
- Tokyo Medical and Dental University, Japan
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Chen CW, Liu YS, Chen CY, Tsai HM, Chen SC, Chuang MT. Use of carbon dioxide as negative contrast agent for magnetic resonance cholangiopancreatography. World J Radiol 2011; 3:47-50. [PMID: 21390193 PMCID: PMC3051110 DOI: 10.4329/wjr.v3.i2.47] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2010] [Revised: 12/28/2010] [Accepted: 01/04/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the effects of using CO2 as negative contrast agent in decreasing the overlapping on the pancreaticobiliary system from intestinal fluids.
METHODS: We evaluated the magnetic resonance cholangiopancreatography (MRCP) images in 117 patients divided into two groups (group 1, without taking gas producing crystals to produce CO2, n = 64; group 2, with CO2, n = 53) in a 1.5T unit using MRCP sequence. Anatomic locations of intestinal fluids distribution, overlapping with common bile duct (CBD) and pancreatic duct (PD), were evaluated.
RESULTS: In the group with CO2, the decrease in distribution of intestinal fluids was significant in the gastric antrum (P = 0.001) and duodenal bulb (P < 0.001), but not in the gastric fundus and body and in the second portion of the duodenum (P = 1.000, P = 0.171, and P = 0.584 respectively). In the group with CO2, the decrease in overlapping with CBD was significant (P < 0.001), but the decrease in overlapping with PD was not (P = 0.106).
CONCLUSION: MRCP with carbon dioxide as negative contrast agent would decrease intestinal fluids in the gastric antrum and duodenal bulb, thereby decreasing overlapping with the CBD.
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Brugger PC, Weber M, Prayer D. Magnetic resonance imaging of the fetal gallbladder and bile. Eur Radiol 2010; 20:2862-9. [DOI: 10.1007/s00330-010-1856-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Revised: 05/24/2010] [Accepted: 05/31/2010] [Indexed: 11/28/2022]
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Morita S, Ueno E, Masukawa A, Suzuki K, Fujimura M, Hirabayashi N, Kojima S, Hirata M, Kitajima K, Kaji Y. Prospective comparative study of negative oral contrast agents for magnetic resonance cholangiopancreatography. Jpn J Radiol 2010; 28:117-22. [PMID: 20182846 DOI: 10.1007/s11604-009-0395-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Accepted: 11/02/2009] [Indexed: 02/01/2023]
Abstract
PURPOSE The aim of this study was to compare prospectively the image quality of magnetic resonance cholangiopancreatography (MRCP) using manganese chloride tetrahydrate (Bothdel Oral Solution 10) (MCT), a new negative oral contrast agent; ferric ammonium citrate (FerriSeltz powder 20%) (FAC); and no agent. MATERIALS AND METHODS MRCP images (TE 970 ms) of patients administered MCT (n = 19) or FAC (n = 20) at random, and 18 patients without an agent were evaluated. The subjective image quality of the overall, extrahepatic bile duct, and pancreatic duct and the degree of elimination of gastrointestinal fluid scored by two radiologists blinded to information regarding the agent were compared using Mann-Whitney's U-test. RESULTS The degrees of elimination of gastroduodenal fluid of MCT and FAC were significantly better than those without an agent (P < 0.01 and P < 0.01). The subjective image quality of MCT of the overall and extrahepatic bile duct were significantly better, although no significant differences for FAC were observed compared with those without an agent (P < 0.01 and P = 0.21, P = 0.02 and P = 0.16). There were no significant differences for the pancreatic duct (P = 0.12 and P = 0.19), nor were there any significant differences in the evaluations between MCT and FAC (P = 0.19-0.98). CONCLUSION MCT has shown performance comparable to that of conventional FAC in terms of pancreatic and biliary depiction and safety.
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Affiliation(s)
- Satoru Morita
- Department of Radiology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
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Alexopoulou E, Roma E, Loggitsi D, Economopoulos N, Papakonstantinou O, Panagiotou I, Pahoula I, Kelekis NL. Magnetic resonance imaging of the small bowel in children with idiopathic inflammatory bowel disease: evaluation of disease activity. Pediatr Radiol 2009; 39:791-7. [PMID: 19452148 DOI: 10.1007/s00247-009-1272-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2008] [Revised: 02/21/2009] [Accepted: 03/22/2009] [Indexed: 01/02/2023]
Abstract
BACKGROUND Examinations using ionizing radiation are frequently used in the evaluation of disease activity in children affected by idiopathic inflammatory bowel disease (IBD). OBJECTIVE To develop an MR imaging protocol without the need for fluoroscopic insertion of an enteral tube and to assess the disease activity in children with IBD. MATERIALS AND METHODS Included in the study were 37 children (22 girls and 15 boys; age range 7-15 years, mean 11.67 years) with IBD who underwent MR imaging of the small bowel. Of these 37 children, 32 had Crohn disease and 5 had indeterminate colitis. A water solution containing herbal fibres was administered orally or through a nasogastric tube. Patients were imaged on a 1.5-T MR scanner with T1-weighted and Tau2-weighted sequences followed by a dynamic study using 3-D T1-W images after intravenous administration of gadolinium. RESULTS The percentage enhancement of the bowel wall was significantly increased in patients with abnormal C-reactive protein (CRP) values compared to patients with CRP values in the normal range (P<0.001). A relatively weak but significant correlation between percentage enhancement of the bowel wall and CRP values was noted during all phases of enhancement. CONCLUSION This MR imaging protocol is a safe and well-tolerated method for evaluating disease activity and extraintestinal manifestations of IBD in children.
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Affiliation(s)
- Efthymia Alexopoulou
- Second Department of Radiology, National and Kapodistrian University of Athens, General University Hospital, Attikon, Rimini 1 Street, Athens, 12462, Greece
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RODITI G, KUSUMAWIDJAJA D. Magnetic resonance angiography and computed tomography angiography for peripheral arterial disease. IMAGING 2009. [DOI: 10.1259/imaging/55671114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Alexopoulou E, Roma E, Loggitsi D, Economopoulos N, Papakonstantinou O, Panagiotou I, Pahoula I, Kelekis NL. Magnetic resonance imaging of the small bowel in children with idiopathic inflammatory bowel disease: evaluation of disease activity. Pediatr Radiol 2009. [PMID: 19452148 DOI: 10.1007/s00247-009-1272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Examinations using ionizing radiation are frequently used in the evaluation of disease activity in children affected by idiopathic inflammatory bowel disease (IBD). OBJECTIVE To develop an MR imaging protocol without the need for fluoroscopic insertion of an enteral tube and to assess the disease activity in children with IBD. MATERIALS AND METHODS Included in the study were 37 children (22 girls and 15 boys; age range 7-15 years, mean 11.67 years) with IBD who underwent MR imaging of the small bowel. Of these 37 children, 32 had Crohn disease and 5 had indeterminate colitis. A water solution containing herbal fibres was administered orally or through a nasogastric tube. Patients were imaged on a 1.5-T MR scanner with T1-weighted and Tau2-weighted sequences followed by a dynamic study using 3-D T1-W images after intravenous administration of gadolinium. RESULTS The percentage enhancement of the bowel wall was significantly increased in patients with abnormal C-reactive protein (CRP) values compared to patients with CRP values in the normal range (P<0.001). A relatively weak but significant correlation between percentage enhancement of the bowel wall and CRP values was noted during all phases of enhancement. CONCLUSION This MR imaging protocol is a safe and well-tolerated method for evaluating disease activity and extraintestinal manifestations of IBD in children.
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Affiliation(s)
- Efthymia Alexopoulou
- Second Department of Radiology, National and Kapodistrian University of Athens, General University Hospital, Attikon, Rimini 1 Street, Athens, 12462, Greece
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Breyer T, Echternach M, Arndt S, Richter B, Speck O, Schumacher M, Markl M. Dynamic magnetic resonance imaging of swallowing and laryngeal motion using parallel imaging at 3 T. Magn Reson Imaging 2008; 27:48-54. [PMID: 18617347 DOI: 10.1016/j.mri.2008.05.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2008] [Revised: 05/23/2008] [Accepted: 05/23/2008] [Indexed: 10/21/2022]
Abstract
OBJECT To evaluate the feasibility of an optimized MRI protocol based on high field imaging at 3 T in combination with accelerated data acquisition by parallel imaging for the analysis of oropharyngeal and laryngeal function. MATERIALS AND METHODS Fast 2D gradient echo (GRE) MRI with different spatial resolutions (1.7x2.7 and 1.1x1.5 mm2) and image update rates (4 and 10 frames per second) was employed to assess pharyngeal movements and visualize swallowing via tracking of an oral contrast bolus (blueberry juice). In a study with 10 normal volunteers, image quality was semi-quantitatively graded by three independent observers with respect to the delineation of anatomical detail and depiction of oropharynx and larynx function. Additionally, the feasibility of the technique for the visualization of pathological pre- and post-surgical oropharynx and larynx function was evaluated in a patient with inspiratory stridor. RESULTS Image grading demonstrated the feasibility of dynamic MRI for the assessment of normal oropharynx and larynx anatomy and function. Superior image quality (P<.05) was found for data acquisition with four frames per second and higher spatial resolution. In the patient, dynamic MRI detected pathological hypermobility of the epiglottis resulting in airway obstruction. Additional post-surgical MRI for one clinical case revealed morphological changes of the epiglottis and improved function, i.e., absence of airway obstruction and normal swallowing. CONCLUSION Results of the volunteer study demonstrated the feasibility of dynamic MRI at 3 T for the visualization of the oropharynx and larynx function during breathing, movements of the tongue and swallowing. Future studies are necessary to evaluate its clinical value compared to existing modalities based on endoscopy or radiographic techniques.
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Affiliation(s)
- Tobias Breyer
- Section of Neuroradiology, Freiburg Institute of Musicians Medicine, Department of Otorhinolaryngology, University of Freiburg, 79106 Freiburg, Germany
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Zhu J, Xu JR, Gong HX, Zhou Y. Updating magnetic resonance imaging of small bowel: Imaging protocols and clinical indications. World J Gastroenterol 2008; 14:3403-9. [PMID: 18528938 PMCID: PMC2716595 DOI: 10.3748/wjg.14.3403] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
High soft tissue contrast resolution, acquisition of multi-planar images and the possibility to obtain functional information make magnetic resonance an interesting imaging technique to evaluate the small bowel disease. The absence of ionizing radiation is an important feature of magnetic resonance imaging (MRI) examinations because inflammatory diseases such as Crohn’s disease (CD) are studied most frequently, which are prevalent among children and young adults. MRI, using modern equipment and a rigorous technical approach, can offer detailed morphologic information and functional data on the small bowel. This article discusses the MRI protocols for small bowel and the MR imaging findings of small bowel diseases, such as CD and small bowel neoplasms.
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Arrivé L, Coudray C, Azizi L, Lewin M, Hoeffel C, Monnier-Cholley L, Lacombe C, Vautier S, Poupon J, Tubiana JM. [Pineapple juice as a negative oral contrast agent in magnetic resonance cholangiopancreatography]. ACTA ACUST UNITED AC 2008; 88:1689-94. [PMID: 18065928 DOI: 10.1016/s0221-0363(07)74047-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE The quality of magnetic resonance cholangiopancreatography (MRCP) images is frequently degraded by high signal from the gastrointestinal tract on heavily T2W images. The purpose of this study is to evaluate pineapple juice (PJ) as an oral negative contrast agent in MRCP. MATERIALS AND METHODS Results from MRCP in 50 patients with PJ and 50 patients with paramagnetic contrast (ferumoxsil-Lumirem) were compared. Reviewers were blinded to the type of contrast agent. Exam quality was recorded with regards to signal suppression in the stomach, duodenum and proximal small bowel and with regards to pancreatic duct and biliary ducts visualization. In vitro, the signal characteristics of several commercially available brands of PJ were assessed using T1W, T2W and MRCP sequences. Signal intensity was correlated with the manganese concentration measured using atomic absorption spectrometry. Finally, the reviewers compared the taste of PJ and ferumoxsil. RESULTS On MRCP sequences, results were similar with regards to signal suppression in the stomach, duodenum and proximal small bowel with PJ and ferumoxsil. Visualization of the pancreatic duct, intrahgepatic bile ducts and CBD was similar with PJ and ferumoxsil. The signal intensity of commercially available brands of PJ on T2W and MRCP sequences correlated well with the measured manganese concentration on spectroscopy. Variations in manganese concentration were observed, with values ranging from 3.65 to 27.24 mg/L. The reviewers noted that PJ tasted "good" or "very good" and that ferumoxsil tasted "bad" or "very bad". CONCLUSION Ingestion of PJ provides effective signal suppression in the GI tract on MRCP, similar to paramagnetic contrast agents. Because manganese concentration is highly variable in commercially available PJ brands, a brand with high manganese concentration should be selected.
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Affiliation(s)
- L Arrivé
- Service de radiologie, Assistance-Publique-Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, Hôpital Saint-Antoine, 184, rue du Faubourg Saint-Antoine, 75012 Paris.
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Sirvanci M, Duran C, Ozturk E, Balci D, Dayangaç M, Onat L, Yüzer Y, Tokat Y, Killi R. The value of magnetic resonance cholangiography in the preoperative assessment of living liver donors. Clin Imaging 2008; 31:401-5. [PMID: 17996603 DOI: 10.1016/j.clinimag.2007.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2007] [Accepted: 04/25/2007] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the ability of magnetic resonance cholangiography (MRC) in the depiction of biliary anatomy of living liver donors by using intraoperative cholangiography (IOC) as a gold standard. MATERIALS AND METHODS Between 2004 and 2006, 86 potential adult-to-adult living donor liver transplantation donors had preoperative MRC at our institution. Of these, 24 potential donors were excluded due to various clinical factors. A total of 62 of these individuals were selected for liver donation and included in the study. MRC was performed on a 1.5-T scanner with breath-hold, rapid acquisition with relaxation enhancement (RARE) sequence with half-Fourier acquisition (HASTE; Siemens) and free-breathing, three-dimensional turbo spin-echo sequence with respiratory triggering. Thin- and thick-slab imaging techniques were employed with half-Fourier RARE MRC. IOC was performed in all 63 cases. The images of IOC and MRC were classified according to a modified Huang classification, independently. The results of the MRC were then compared with the IOC results. RESULTS IOC was used as the reference standard; a total of 43 (69.3%) liver donors were considered to have normal biliary anatomy, whereas 19 (30.7%) were considered to have variants of biliary anatomy. Compared with IOC, MRC correctly revealed biliary anatomy in 59 of 62 (95.1%) donors. The sensitivity, specificity, positive predictive value and negative predictive value of MRC in distinguishing normal and any type of variant biliary anatomy were 84.2%, 100%, 100%, and 93.4%, respectively. CONCLUSION MRC is an effective imaging technique for the preoperative evaluation of the biliary anatomy in living liver donors. However, MRC and IOC should be considered complementary to one another in order to avoid complications.
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Affiliation(s)
- Mustafa Sirvanci
- Department of Radiology, Florence Nightingale Hospital, Istanbul, Turkey
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Chang EY, Li X, Jerosch-Herold M, Priest RA, Enestvedt CK, Xu J, Springer CS, Jobe BA. The evaluation of esophageal adenocarcinoma using dynamic contrast-enhanced magnetic resonance imaging. J Gastrointest Surg 2008; 12:166-75. [PMID: 17768665 DOI: 10.1007/s11605-007-0253-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2007] [Accepted: 07/19/2007] [Indexed: 01/31/2023]
Abstract
Although neoadjuvant chemoradiation eradicates esophageal adenocarcinoma in a substantial proportion of patients, conventional imaging techniques cannot accurately detect this response. Dynamic contrast-enhanced magnetic resonance imaging is an emerging approach that may be well suited to fill this role. This pilot study evaluates the ability of this method to discriminate adenocarcinoma from normal esophageal tissue. Patients with esophageal adenocarcinoma and control subjects underwent scanning. Patients treated with neoadjuvant therapy underwent pre- and postchemoradiation scans. Parameters were extracted for each pixel were Ktrans (equilibrium rate for transfer of contrast reagent across the vascular wall), ve (volume fraction of interstitial space), and taui (mean intracellular water lifetime). Five esophageal adenocarcinoma patients and two tumor-free control subjects underwent scanning. The mean Ktrans value was 5.7 times greater in esophageal adenocarcinoma, and taui is 2.0 times smaller, than in the control subjects. Ktrans decreased by 11.4-fold after chemoradiation. Parametric maps qualitatively demonstrate a difference in Ktrans. DCE MRI of the esophagus is feasible. Ktrans, a parameter that has demonstrated discriminative ability in other malignancies, also shows promise in differentiating esophageal adenocarcinoma from benign tissue. The determination of Ktrans represents an in vivo assay for endothelial permeability and thus may serve as a quantitative measure of response to induction chemoradiation.
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Affiliation(s)
- Eugene Y Chang
- Department of Surgery, Oregon Health & Science University, Mail Code L223, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, USA
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Hirohashi S. CMR 2007: 13.03: New manganese-based oral contrast medium for MR cholangiopancreatography. CONTRAST MEDIA & MOLECULAR IMAGING 2007. [DOI: 10.1002/cmmi.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
The study is to determine the optimal MRI bowel preparation regime for visualization of the stomach anatomy. Eight healthy volunteers were asked to take water, 75% barium and blueberry juice. The image quality and tolerance of different stomach distension regime were evaluated. Blueberry juice gave the best distension, but the signal intensity was not very homogeneous. Taking into account the image quality, tolerability and adverse effects, it is concluded that water is the most desirable oral contrast for MR stomach imaging.
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Affiliation(s)
- W W M Lam
- Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR.
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29
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Babos M, Schwarcz A, Randhawa MS, Marton B, Kardos L, Palkó A. In vitro evaluation of alternative oral contrast agents for MRI of the gastrointestinal tract. Eur J Radiol 2007; 65:133-9. [PMID: 17485189 DOI: 10.1016/j.ejrad.2007.03.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Revised: 01/14/2007] [Accepted: 03/21/2007] [Indexed: 11/24/2022]
Abstract
PURPOSE In vitro evaluation of different materials as potential alternative oral contrast agents for small bowel MRI. MATERIALS AND METHODS The T1 and T2 relaxation times of rose hip syrup, black currant extract, cocoa, iron-deferoxamine solution and a commonly used oral contrast material (1 mM Gd-DTPA) were determined in vitro at different concentrations on a 1.0 T clinical MR scanner. T1 values were obtained with an inversion prepared spoiled gradient echo sequence. T2 values were obtained using multiple echo sequences. Finally the materials were visualized on T1-, T2- and T2*-weighted MR images. RESULTS The relaxation times of the undiluted rose hip syrup (T1=110+/-5 ms, T2=86+/-3 ms), black currant extract (T1=55+/-3 ms, T2=39+/-2 ms) and 5 mM iron-deferoxamine solution (T1=104+/-4 ms, T2=87+/-2 ms) were much shorter than for a 1mM Gd-DTPA solution (T1=180+/-8 ms, T2=168+/-5 ms). Dilution of black currant extract to 30% or a 3 mM iron-deferoxamine solution conducted to T1 relaxation times which are quite comparable to a 1 mM Gd-DTPA solution. Despite its much lower metal content an aqueous cocoa suspension (100 g/L) produced T2 relaxation times (T1=360+/-21 ms, T2=81+/-3 ms) more or less in the same range like the 5 mM iron-deferoxamine solution. Imaging of our in vitro model using clinical sequences allowed to anticipate the T1-, T2- and T2*-depiction of all used substances. Cocoa differed from all other materials with its low to moderate signal intensity on T1- and T2-weighted sequences. While all substances presented a linear 1/T1 and 1/T2 relationship towards concentration, rose hip syrup broke ranks with a disproportionately high increase of relaxation at higher concentrations. CONCLUSIONS Rose hip syrup, black currant extract and iron-deferoxamine solution due to their positive T1 enhancement characteristics and drinkability appear to be valuable oral contrast agents for T1-weighted small bowel MRI. Cocoa with its differing relaxation and signal enhancement properties is a promising oral contrast agent but needs further clinical evaluation.
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Affiliation(s)
- Magor Babos
- University of Szeged, Faculty of Science, Hungary.
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Stork H, Gädke A, Nestle N. Single-sided and semisingle-sided NMR sensors for highly diffusive samples: application to bottled beverages. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2006; 54:5247-52. [PMID: 16848502 DOI: 10.1021/jf060431m] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Single-sided NMR sensors such as the NMR-MOUSE have been very successfully implemented for quality control applications in the rubber and polymer industries. More recently, single-sided NMR was also applied in characterization of the fat components in foods. Both industrial polymers and the fat components in food exhibit relatively low self-diffusion coefficients on the order of 5x10(-11) m2/s or lower. The application of conventional single-sided NMR to highly mobile, watery phases in foods and beverages is hampered by the strong magnetic field gradient present in standard single-sided NMR devices. In this contribution, we present both a single-sided NMR sensor with a reduced magnetic field gradient and another ("semisingle-sided") sensor design with an open sample bay using a single-sided RF coil. The latter design allows much better sensitivity without sacrificing the necessary open access needed for measurements on entire food packages such as bottles. As a first application, the sensors were used for determining the oxygen content in bottles with superoxygenated table water.
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Affiliation(s)
- Holger Stork
- Institute of Condensed Matter Physics, TU Darmstadt, Hochschulstrasse 6, D-64289 Darmstadt, Germany
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Takemoto H, Honda K, Masaki S, Shimada Y, Fujimoto I. Measurement of temporal changes in vocal tract area function from 3D cine-MRI data. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2006; 119:1037-49. [PMID: 16521766 DOI: 10.1121/1.2151823] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
A 3D cine-MRI technique was developed based on a synchronized sampling method [Masaki et al., J. Acoust. Soc. Jpn. E 20, 375-379 (1999)] to measure the temporal changes in the vocal tract area function during a short utterance /aiueo/ in Japanese. A time series of head-neck volumes was obtained after 640 repetitions of the utterance produced by a male speaker, from which area functions were extracted frame-by-frame. A region-based analysis showed that the volumes of the front and back cavities tend to change reciprocally and that the areas near the larynx and posterior edge of the hard palate were almost constant throughout the utterance. The lower four formants were calculated from all the area functions and compared with those of natural speech sounds. The mean absolute percent error between calculated and measured formants among all the frames was 4.5%. The comparison of vocal tract shapes for the five vowels with those from the static MRI method suggested a problem of MRI observation of the vocal tract: data from static MRI tend to result in a deviation from natural vocal tract geometry because of the gravity effect.
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Affiliation(s)
- Hironori Takemoto
- ATR Human Information Science Laboratories, 2-2-2 Hikaridai, Seika-cho, Soraku-gun, Kyoto, 619-0288 Japan
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Nestle N, Pauls S, Wunderlich A. Oral magnetic resonance imaging contrast agent based onIlex paraguayensis herbal extract. Magn Reson Med 2006; 55:923-9. [PMID: 16538607 DOI: 10.1002/mrm.20837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this article we demonstrate the potential of herbal extracts from yerba mate (Ilex paraguayensis) as an oral contrast agent for MRI. At typical drinking concentrations, yerba mate acts as a "biphasic" contrast agent with T1 weighting at short echo times and T2 weighting at echo times greater than about 40 ms. Based on data obtained from X-ray fluorescence elemental analysis, NMR relaxometry, and ESR we identify the relaxation agent in the extract as a low-molecular-weight manganese complex. Yerba mate exhibits an unusually high manganese content that is readily available for hot water extraction. Despite the high elemental manganese levels in I. paraguayensis extract, no manganese-related toxicity of yerba mate has been observed even among heavy yerba mate drinkers, indicating that the manganese in the extract has only a very low bioavailability. Imaging results on staff and patient volunteers demonstrate good contrasting of the GI tract. The relaxation studies of the contrast agent show a sensitivity to pH that is consistent with imaging results from stomach and small bowel.
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Affiliation(s)
- Nikolaus Nestle
- Institut for Condensed Matter Physics, TU Darmstadt, Darmstadt, Germany.
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Espinosa MG, Sosa M, De León-Rodríguez LM, Córdova T, Bernal-Alvarado J, Avila-Rodríguez M, Reyes-Aguilera JA, Ortíz JJ, Barrios FA. Blackberry (Rubus spp.): a pH-dependent oral contrast medium for gastrointestinal tract images by magnetic resonance imaging. Magn Reson Imaging 2005; 24:195-200. [PMID: 16455409 DOI: 10.1016/j.mri.2005.10.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2005] [Revised: 10/16/2005] [Accepted: 10/16/2005] [Indexed: 10/25/2022]
Abstract
In this study, seven fruits have been tested on their magnetic properties, paramagnetic metal content and contrast enhancement in magnetic resonance imaging (MRI) of phantom and in vivo. Magnetic susceptibility was determined for the fruit pulps, as well as the contents of paramagnetic metals; iron, manganese and copper. The total content of these metals was 4.3, 8.6, 11.1, 10.9, 12.3, 8.3 and 29.3 mg/kg of fruit for plum, blueberry, apple (red), pineapple, beet, grape, blackberry, respectively, and with magnetic susceptibility of -2.29+/-0.07, -2.43+/-0.07, -2.13+/-0.07, -1.84+/-0.02, -1.75+/-0.01, -1.78+/-0.06, -2.18+/-0.07 SI, respectively. T(1)- and T(2)-weighted MR images were performed for the seven fruits and water (chi= -9.98 x 10(-3) SI) and in one subject. While there was no correlation between the magnetic susceptibility and contrast enhancement, there is a correlation with the total paramagnetic metal content determined with contrast enhancement in MRI. Thus, blackberry (Rubus spp.) contrast enhancement was the highest among the fruits in T(1)-weighted images. Furthermore, this fruit's contrast enhancement shows to be pH-dependent. These characteristics and the wide availability of the Rubus spp. suggest that it should be implemented as an oral contrast agent in images by MR to assess the function of the gastric section of the GI tract. Furthermore, it has the advantage of being a natural meal, so that it can be well tolerated by the patients and use as much as it is needed without side effects.
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Affiliation(s)
- María G Espinosa
- Facultad de Física e Inteligencia Artificial, Universidad Veracruzana, 91090 Xalapa, Ver., México
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Coppens E, Metens T, Winant C, Matos C. Pineapple juice labeled with gadolinium: a convenient oral contrast for magnetic resonance cholangiopancreatography. Eur Radiol 2005; 15:2122-9. [PMID: 15999215 DOI: 10.1007/s00330-005-2835-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2005] [Revised: 05/11/2005] [Accepted: 05/31/2005] [Indexed: 12/15/2022]
Abstract
The aim of our study was to prepare in vitro a pineapple juice (PJ) solution labeled with a minimal gadolinium concentration working as a negative contrast agent in heavily T2-weighted imaging and to assess that solution in vivo as a negative oral contrast agent for magnetic resonance cholangiopancreatography (MRCP). Three PJs were compared in vitro according to their T2. Increasing concentrations of gadolinium (Gd)-DOTA in PJ were assessed in vitro for T2 reduction. Single-shot turbo spin echo T2-weighted MR cholangiopancreatograms were obtained for 35 patients with suspected biliopancreatic duct disease, before and after ingestion of the PJ/Gd-DOTA solution. Signal intensity (SI) measurements of gastroduodenal lumens, pancreatobiliary ducts, and image quality scores were obtained systematically before and after contrast ingestion. The in vitro selected Gd-DOTA concentration in the PJ was 2.76 mmol/l. Ingestion of 180 ml of PJ labeled with 1 ml of Gd-DOTA eliminated efficiently the gastroduodenal SI in MRCP, improving significantly the rates of complete visualization of the pancreatobiliary ducts (P<0.01) and the MRCP image quality scores (P<0.05). All patients easily ingested the contrast solution and found the solution palatable. PJ labeled with gadolinium constituted an efficient and convenient negative oral contrast agent for MRCP.
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Affiliation(s)
- Emmanuel Coppens
- Department of Radiology, Division of Magnetic Resonance, Hôpital Erasme, Université Libre de Bruxelles, 808 route de Lennik, 1070, Brussels, Belgium.
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Cooper JA. Responsible conduct of radiology research: part I. The regulatory framework for human research. Radiology 2005; 236:379-81. [PMID: 15972341 DOI: 10.1148/radiol.2362031633] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of the articles in this series is to explain the ethical and legal basis for responsible conduct of radiology research. In the current article, the regulatory framework of human research is explained. There is no overall regulatory process for protecting the rights and welfare of humans participating in research. Instead, legal protections in the United States are an amalgam of regulations from multiple federal and state agencies. The key regulations are from the Department of Health and Human Services, the Food and Drug Administration, and the Federal Privacy Rule of the Health Insurance Portability and Accountability Act. Which of these apply in any situation depends on many factors, including the funding source of the research, the site of the research, and the items being tested. Radiologists conducting human research need to know which regulations apply and how to comply with them. The regulations represent a set of rules based on the ethical principles of respect for persons, beneficence, and justice. Radiologists should understand these ethical principles for situations when the regulations are silent, ambiguous, or incomplete. (c) RSNA, 2005.
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Affiliation(s)
- Jeffrey A Cooper
- Association for the Accreditation of Human Research Protection Programs, 915 15th St NW, Suite 400, Washington, DC 20005-2315, USA.
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Abstract
MR imaging is an established technique for the diagnosis of a spectrum of biliary and gallbladder pathologies and continues to improve with the advent of technologic advances, including new contrast agents and new sequences that are capable of improving upon the contrast resolution and signal-to-noise that are afforded by conventional MR imaging. These improvements already have shown promise for the increasing role of MRC as the initial modality in assessing living liver donors and evaluating post-operative hepato-biliary complications. Improved spatial resolution and the added functional or physiologic information afforded by MR imaging promise ever expanding clinical applicability and usefulness.
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Affiliation(s)
- Samantha L Heller
- Department of Radiology, New York University Medical Center, 530 First Avenue, New York, NY 10016, USA
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Borthne AS, Abdelnoor M, Hellund JC, Geitung JT, Storaas T, Gjesdal KI, Kløw NE. MR imaging of the small bowel with increasing concentrations of an oral osmotic agent. Eur Radiol 2005; 15:666-71. [PMID: 15700173 DOI: 10.1007/s00330-004-2636-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2004] [Revised: 12/01/2004] [Accepted: 12/08/2004] [Indexed: 12/23/2022]
Abstract
The aim of this study was to assess the quality of MR imaging and level of adverse effects with increasing concentrations of gastrografin. This is a prospective study with 24 healthy volunteers which were randomised into four groups receiving 50%, 25%, 10% and 0% gastrografin. The endpoint was bowel image quality based on distension, signal homogeneity and wall delineation evaluated by three independent radiologists, and the maximum bowel diameter at three different levels. The subjects also scored any adverse events on a 1-5 scale. The interradiologist agreement was relatively good, with kappa values varying between 0.81 and 0.41. Improved bowel distension and image quality were achieved with increasing concentrations. But significant dose-response effects were found between increasing osmolalities and the bowel diameters and also versus the score of adverse events. The most frequent adverse reactions were diarrhea, nausea and lack of palatability. There is a gradient relationship between increasing osmolality of gastrografin and improved image quality and the score of adverse effects. The optimum concentration of gastrografin is dependent of the tolerance of the adverse events.
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Affiliation(s)
- Arne S Borthne
- Department of Radiology, Ullevaal University Hospital, Kirkeveien 166, 0407 Oslo, Norway.
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Riordan RD, Khonsari M, Jeffries J, Maskell GF, Cook PG. Pineapple juice as a negative oral contrast agent in magnetic resonance cholangiopancreatography: a preliminary evaluation. Br J Radiol 2005; 77:991-9. [PMID: 15569640 DOI: 10.1259/bjr/36674326] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The quality of magnetic resonance cholangiopancreatography (MRCP) images is frequently degraded by high signal from the gastrointestinal tract. The aim of this study is to evaluate pineapple juice (PJ) as an oral negative contrast agent in MRCP. Preliminary in vitro evaluation demonstrated that PJ shortened T(2) relaxation time and hence decreased T(2) signal intensity on a standard MRCP sequence to a similar degree to a commercially available negative contrast agent (ferumoxsil). Electrothermal atomic absorption spectrometry assay demonstrated a high manganese concentration in PJ of 2.76 mg dl(-1), which is likely to be responsible for its T(2) imaging properties. MRCP was subsequently performed in 10 healthy volunteers, before and at 15 min and 30 min following ingestion of 400 ml of PJ. Images were assessed blindly by two Consultant Radiologists using a standard grading technique based on contrast effect (degree of suppression of bowel signal), and image effect (diagnostic quality). There were statistically significant improvements in contrast and image effect between pre and post PJ images. There was particularly significant improvement in visualization of the pancreatic duct, but no significant difference between 15 min and 30 min post PJ images. Visualization of the ampulla, common bile duct, common hepatic and central intrahepatic ducts were also significantly improved at 15 min following PJ. Our results demonstrate that PJ, may be used as an alternative to commercially available negative oral contrast agent in MRCP.
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Affiliation(s)
- R D Riordan
- Department of Radiology, Royal Cornwall Hospital, Truro, Cornwall TR1 3LJ, UK
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Pilleul F, Beuf O. IRM et exploration du tube digestif — Aspects techniques et perspectives d’évolution. ACTA ACUST UNITED AC 2004; 85:1985-91. [PMID: 15692408 DOI: 10.1016/s0221-0363(04)97770-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Barium enema remains the reference method for the detection of morphological intraluminal alterations of the bowel. Optimal filling of intestinal loops allows high diagnostic sensitivity and specificity. US, CT and MRI are useful diagnostic procedures in the evaluation of mural and extramural alterations. In recent years, MR-enteroclysis and MR colonography have been developed, both enable the evaluation of luminal, extraluminal and mural alterations of the bowel. While these modalities provide good imaging evaluation of the bowel, visualization of the different layers, as seen on US, is still not available. Use of high resolution endoluminal coil on MR could improve mural evaluation of bowel to differentiate inflammatory diseases and provide accurate TNM classification of tumoral lesion with minimally invasive procedure.
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Affiliation(s)
- F Pilleul
- Service de Radiologie Digestive, Pavillon H, Hôpital Edouard Herriot, 69003 Lyon.
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Abstract
RATIONALE AND OBJECTIVES Manganese is a well-known liver-specific agent used in magnetic resonance imaging. For this purpose, manganese is now administered intravenously. In theory it should be possible to increase the gastrointestinal uptake of manganese through the use of nutritional products as promoters. Such an agent has now been formulated. As part of a primary pharmacologic investigation, the uptake of manganese in the kidney, heart, and liver was studied. MATERIALS AND METHODS One hundred two female Sprague Dawley rats fasted for 18 hours before the agent (CMC-001) was given orally by gavage. One hundred micromol/kg BW was given to all rats except six, who served as controls. Various concentrations of the promoters (vitamin D3 and the amino acid alanine) were also given. Three hours after administration the rats were killed and the heart, the liver and kidneys were removed. The manganese content was determined by atomic absorption. RESULTS No systematic increased concentration of manganese was found in either the kidneys or the heart; whereas the manganese content of the liver (approximately 100%) increased significantly compared with the controls and the group receiving pure manganese. No side effects were observed. CONCLUSION It is possible to increase the gastrointestinal uptake of manganese in fasting rats and thereby increase the concentration in the liver.
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Affiliation(s)
- Henrik S Thomsen
- Department of Diagnostic Radiology 54E2, Copenhagen University Hospital at Herlev, Herlev Ringvej 75, DK-2730, Herlev, Denmark
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Schreyer AG, Fürst A, Agha A, Kikinis R, Scheibl K, Schölmerich J, Feuerbach S, Herfarth H, Seitz J. Magnetic resonance imaging based colonography for diagnosis and assessment of diverticulosis and diverticulitis. Int J Colorectal Dis 2004; 19:474-80. [PMID: 15088109 DOI: 10.1007/s00384-004-0587-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/09/2004] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS MRI-based colonography is a new minimally invasive imaging modality to assess the colon and abdomen. This new method which is applied mainly for polyp screening could be an integrative approach for colonic diverticulitis assessment. This study evaluated the feasibility of MRI-based colonography to assess diverticulosis or diverticulitis. PATIENTS AND METHODS Fourteen consecutive patients with clinically suspected diverticulitis were examined by MRI colonography on a 1.5-T scanner. All patients underwent abdominal CT as gold standard. N-Butyl-scopalamin was given intravenously to reduce bowel peristalsis. After rectal administration of a T1-positive enema T1- and T2-weighted acquisitions with additional intravenous contrast were obtained. A 3D FLASH sequence was acquired for virtual colonography. The results were compared with CT and biological parameters such as white blood cell count and C-reactive protein. RESULTS Of 56 bowel segments (sigmoid colon, descending colon, transverse colon, ascending colon) in all 14 patients 54 were assessed to have good to fair image quality. Having CT as standard of reference, all sigmoid diverticula were diagnosed based on MRI. Inflammation as judged by CT was identically assessed on MRI. 3D models of the colon revealed further diverticula in the remaining colon; additionally, the 3D models gave a comprehensive image for surgical planning. CONCLUSION In our preliminary study MRI colonography revealed the same diagnosis as CT in all patients without ionizing radiation. Additionally, 3D-rendered models and virtual colonoscopy can be performed. This comprehensive 3D models could replace presurgical planning barium enema with concurrent assessment of the residual colon.
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Affiliation(s)
- Andreas G Schreyer
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
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Roditi GH, Harold G. Magnetic resonance angiography and computed tomography angiography for peripheral arterial disease. IMAGING 2004. [DOI: 10.1259/imaging/59636918] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Córdova-Fraga T, de Araujo DB, Sanchez TA, Elias J, Carneiro AAO, Brandt-Oliveira R, Sosa M, Baffa O. Euterpe Olerácea (Açaí) as an alternative oral contrast agent in MRI of the gastrointestinal system: preliminary results. Magn Reson Imaging 2004; 22:389-93. [PMID: 15062934 DOI: 10.1016/j.mri.2004.01.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2003] [Accepted: 01/26/2004] [Indexed: 10/26/2022]
Abstract
Using contrast agents is a common practice in medical imaging protocols. Paramagnetic properties of certain compounds present in contrast agents can affect magnetic resonance imaging (MRI) signals. For abdominal applications, they are usually injected, but may also be administered orally. However, their use as a routine technique is limited, mainly due to the lack of appropriate oral contrast agents. We herein present the preliminary characterization and results for implementation of Euterpe Olerácea (popularly named Açaí) as a possible clinical oral contrast agent for MRI of the gastrointestinal tract. The pulp of Açaí, a fruit from the Amazon area, presented an increase in T(1)-weighted MRI signal, equivalent to that of gadolinium-diethyltriamine pentaacetic acid, and a decrease in T(2)-weighted images. We looked for intrinsic properties that could be responsible for the T(1) signal enhancement and T(2) opacification. Atomic absorption spectra revealed the presence of Fe, Mn and Cu ions in Açai. The presence of such ions contribute to the susceptometric value found of chi = -4.83 x 10(-6). This finding assents with the hypothesis that image contrast changes were due to the presence of paramagnetic material. The first measurements in vivo demonstrate a clear increase of contrast, in T(1)-weighted images, due to the presence of Açaí. Consistently, the opacification in a T(2)-weighted acquisition was evident, revealing a good contrast on bowel walls of gastric tissues.
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Affiliation(s)
- T Córdova-Fraga
- Department de Fisica e Matematica, FFCLRP, Universidade de Sao Paulo, Av. Bandeirantes 3900, Ribeirao Preto Sao Paulo 14, 040-91, Brazil
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Pilleul F, Crombe Ternamian A, Fouque P, Valette PJ. Exploration de l’intestin grêle par les techniques d’imagerie en coupes. ACTA ACUST UNITED AC 2004; 85:517-30. [PMID: 15184797 DOI: 10.1016/s0221-0363(04)97624-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Recent advances of cross sectional imaging allow optimal evaluation of the small bowel. This chapter will detail technical considerations and emphasize the role of imaging in the evaluation of the most common diseases of the small bowel.
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Affiliation(s)
- F Pilleul
- Service de Radiologie, Fédération des Spécialités Digestives, Hôpital Edouard Herriot, place d'Arsonval, 69003 Lyon
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Schreyer AG, Seitz J, Feuerbach S, Rogler G, Herfarth H. Modern imaging using computer tomography and magnetic resonance imaging for inflammatory bowel disease (IBD) AU1. Inflamm Bowel Dis 2004; 10:45-54. [PMID: 15058527 DOI: 10.1097/00054725-200401000-00008] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Radiologic imaging--especially of the small bowel--plays an important role in the diagnosis and management of patients with inflammatory bowel disease. The radiographic examination of the small intestine with barium either as enteroclysis or as small bowel follow through are still the mainstays in small bowel imaging. However, abdominal CT or MRI, which has the advantage of not utilizing ionizing radiation, or the techniques of CT- or MR-enteroclysis, are overall comparable with regard to the sensitivity and specificity in detecting intestinal pathologies and have already replaced the conventional techniques in centers dedicated to the management of inflammatory bowel disease. Additionally, these cross-sectional imaging techniques provide, in a sense, a "one stop abdominal imaging workup," the diagnosis of extraluminal disease manifestations or complications. Future developments of CT- or MR-based virtual colonography and endoscopy in patients with inflammatory bowel disease are currently being investigated, but should momentarily be considered as purely experimental approaches.
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Laghi A, Paolantonio P, Iafrate F, Altomari F, Miglio C, Passariello R. Oral contrast agents for magnetic resonance imaging of the bowel. Top Magn Reson Imaging 2002; 13:389-96. [PMID: 12478019 DOI: 10.1097/00002142-200212000-00003] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The development of fast imaging sequences, which provide the ability to acquire motion-free T1- and T2-weighted images of static fluids, has greatly increased the interest in magnetic resonance imaging of the small bowel. Luminal distension is a necessary prerequisite for small bowel imaging methods because collapsed bowel loops can hide even large lesions and may mimic wall thickening. Poor distension of normal bowel loops in basal conditions has led researchers to study different oral contrast media to optimally distend the bowel lumen. Several MR oral contrast agents with various signal properties are available. According to these signal properties, agents are classified as positive ("bright" lumen), negative ("dark" lumen), or biphasic ("bright" lumen on T1 and "dark" on T2, or conversely "dark" lumen on T2 and "bright" on T1). Positive contrast agents cause a reduction in T1 relaxation time; consequently, these agents act on T1-weighted images by increasing the signal intensity of the bowel lumen. Negative contrast agents are based on superparamagnetic particles and act by inducing local field inhomogeneities, which results in shortening of both T1 and T2 relaxation times. Using superparamagnetic contrast agents, T2-weighted effects are predominant. Biphasic contrast agents are substances that have different signal intensities on different sequences, depending on the concentration at which they are administered. The choice of a single agent presents advantages and disadvantages; thus, the radiologist should choose the appropriate contrast medium according to the clinical setting, MR experience, availability of the agent, and patient tolerance.
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Affiliation(s)
- Andrea Laghi
- Department of Radiology, University of Rome La Sapienza, Policlinico Umberto I, Italy.
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Lauenstein TC, Debatin JF. Magnetic resonance colonography with fecal tagging: an innovative approach without bowel cleansing. Top Magn Reson Imaging 2002; 13:435-44. [PMID: 12478023 DOI: 10.1097/00002142-200212000-00007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To date, virtual colonography mandates bowel cleansing in a manner similar to colonoscopy. Because more than half of patients undergoing bowel preparation complain about negative side effects, patient acceptance is negatively impacted. To assure high patient acceptance of MR colonography, bowel cleansing needs to be eliminated. This can be accomplished by fecal tagging, a concept based on altering the signal intensity of stool by adding contrast-modifying substances to regular meals. This article describes different fecal tagging approaches and points out both advantages and limitations of these strategies.
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Affiliation(s)
- Thomas C Lauenstein
- Department of Diagnostic and Interventional Radiology, University Hospital Essen, Germany.
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Schreyer AG, Herfarth H, Kikinis R, Seitz J, Schölmerich J, Geissler A, Feuerbach S. 3D modeling and virtual endoscopy of the small bowel based on magnetic resonance imaging in patients with inflammatory bowel disease. Invest Radiol 2002; 37:528-33. [PMID: 12218449 DOI: 10.1097/00004424-200209000-00008] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
RATIONALE AND OBJECTIVES Small bowel MRI (MR imaging) is a new imaging modality that excellently depicts small intestine pathology in patients with inflammatory bowel disease. Virtual endoscopy based on sectional imaging is a recently introduced technique to create endoscopy like views. The aim of this study was to evaluate the feasibility of virtual small bowel endoscopy based on MR imaging in patients with Crohn disease. MATERIALS AND METHODS Thirty consecutive patients with Crohn disease were scanned after oral application of pineapple juice for contrasting the small bowel. Dedicated high resolution T1 weighted 3D-FLASH sequences with fat suppression were used for volume scanning. Volume-rendered 3D models of the small bowel were created and virtual endoscopy was performed. The feasibility and quality of this new visualization method was assessed. RESULTS In nine of 30 patients virtual endoscopy was considered as good quality (flight through the entire small bowel was possible, typical folds were revealed). In 18 patients fair quality (at least 4/5 of the small bowel were depicted adequately) was assessed. In three of 30 patients virtual endoscopy was not sufficiently possible because of inadequate bowel filling or breathing artifacts. Three fistulae diagnosed on 2D MRI were visualized on the virtual endoscopic view. CONCLUSION Virtual endoscopy of the small bowel is feasible based on high resolution MR imaging. Vivid insight views and 3D models provide an interesting addition to sectional MR findings.
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Kanematsu M, Matsuo M, Shiratori Y, Kondo H, Hoshi H, Yasuda I, Moriwaki H. Thick-section half-Fourier rapid acquisition with relaxation enhancement MR cholangiopancreatography: effects of i.v. administration of gadolinium chelate. AJR Am J Roentgenol 2002; 178:755-61. [PMID: 11856714 DOI: 10.2214/ajr.178.3.1780755] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Our purpose was to investigate the effects of i.v. administration of gadolinium chelate on thick-section MR cholangiopancreatography performed with half-Fourier rapid acquisition with relaxation enhancement sequence. SUBJECTS AND METHODS Unenhanced and enhanced MR cholangiopancreatograms obtained in 50 consecutive patients were quantitatively analyzed with region-of-interest measurements and were qualitatively evaluated by three independent radiologists unaware the patient information. A phantom study was performed to verify the effects. RESULTS The mean contrast-to-noise ratios of the gallbladder, common bile duct, and main pancreatic duct significantly increased after gadolinium chelate administration (p < 0.005). The mean depiction score of the main pancreatic duct increased significantly with one radiologist (p < 0.05) and marginally with another (p < 0.06), and the mean depiction scores of the background structures and renal pelvis significantly decreased with all three radiologists (p < 0.001). The phantom study showed the results, indicating that T2- and T2(*)-shortening effects of gadolinium chelate caused the effects in vivo. CONCLUSION i.v. administration of gadolinium chelate improves the depiction of pancreaticobiliary ducts in some selected patients, while decreasing the depiction in others with less frequency. There may be a value of enhanced MR cholangiopancreatography when unenhanced MR cholangiopancreatography is not sufficient.
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Affiliation(s)
- Masayuki Kanematsu
- Department of Radiology, Gifu University School of Medicine, 40 Tsukasamachi, Gifu, 500-8705, Japan
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