Positive bowel contrast agent for MR imaging of the abdomen: phase II and III clinical trials.
OBJECTIVE
To evaluate the efficacy and safety of two dose levels of an orally administered ferric ammonium citrate-based contrast agent for bowel enhancement on T1-weighted spin-echo magnetic resonance (MR) images in 222 patients with known or suspected abnormality of the upper abdomen.


METHODS
Adverse reactions were graded for intensity, frequency, duration, and relationship to the contrast agent. Twelve unblinded readers compared enhanced with unenhanced images; all MR images were evaluated by two independent offsite radiologists in a blinded review.


RESULTS
No statistically significant changes in mean vital signs or laboratory values were seen. Forty-eight of 220 patients (22%) reported minor side effects. The readers found increased intraluminal signal intensity and improved contrast enhancement of the gastrointestinal tract and distention and improved signal homogeneity in 101-107 cases (89%-98%) after ingestion; the blinded reviewers' findings were similar.


CONCLUSIONS
The contrast agent provided new or additional radiologic information in 142 patients (64%), specific additional information in a detected abnormality in 46 of 142 patients (32%), and information that changed diagnosis, management, or surgical approach in 22 of 142 patients (15%).
Department of Radiology, University of Washington, Seattle.
R M
RM
Patten
S K
SK
Lo
J J
JJ
Phillips
S C
SC
Bowman
G M
GM
Glazer
S D
SD
Wall
J G
JG
Bova
R D
RD
Harris
R L
RL
Wheat
C D
CD
Johnson
D000005:Abdomen / Q000473:pathology*; D000008:Abdominal Neoplasms / Q000175:diagnosis / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D004066:Digestive System Diseases / Q000175:diagnosis / Q000473:pathology; D004305:Dose-Response Relationship, Drug; D004361:Drug Tolerance; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007089:Image Enhancement; D007422:Intestines / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000175:diagnosis / Q000473:pathology; D000644:Quaternary Ammonium Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D012449:Safety
D003287:Contrast Media; D005290:Ferric Compounds; D000644:Quaternary Ammonium Compounds; C013531:ferric ammonium citrate