Hydro-MRI of the small bowel: effect of contrast volume, timing of contrast administration, and data acquisition on bowel distention.
OBJECTIVE
The purpose of this study was to assess oral contrast agents, volumes of the agents, and time points of data acquisition in regard to small-bowel distention and patient acceptance.


METHODS
Six healthy volunteers underwent imaging on 16 different days. Four volumes (450, 900, 1,350, and 1,800 mL) of each of the four contrast compounds (0.2% locust bean gum plus 2.5% mannitol, VoLumen containing 2.0% sorbitol, VoLumen containing 1.4% sorbitol, and tap water) were used. Two-dimensional true fast imaging with steady-state free precession data sets were acquired at 5-minute intervals after contrast ingestion. Distention values for small-bowel segments (duodenum, proximal and distal jejunum, ileum) and occurrence of side effects were documented.


RESULTS
Analysis of bowel distention revealed significantly greater distention for all carbohydrate sugar alcohol-containing solutions compared with water but no significant difference among the three contrast agents. Sufficient duodenal distention was achieved with 900 mL of any of the contrast agents, but imaging had to be performed soon after ingestion. For MRI of the distal jejunum and ileum, a volume of 1,350 mL is preferable, and the time point of data acquisition plays a minor role. Ingestion of 1,800 mL of the carbohydrate sugar alcohol solutions led to a significantly higher rate of side effects such as abdominal cramps than did ingestion of smaller volumes.


CONCLUSIONS
The data indicate that sufficient contrast consumption and optimal timing of data acquisition are essential to distention of the small bowel. Oral contrast agent protocols should be adapted to the bowel region in question.
Kuehle
Christiane A
CA
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany. christiane.kuehle@uni-essen.de
Ajaj
Waleed
W
Ladd
Susanne C
SC
Massing
Sandra
S
Barkhausen
Joerg
J
Lauenstein
Thomas C
TC
D000284:Administration, Oral; D000328:Adult; D003287:Contrast Media / Q000008:administration & dosage*; D004386:Duodenum / Q000033:anatomy & histology* / Q000502:physiology; D005260:Female; D005685:Galactans / Q000008:administration & dosage; D006801:Humans; D007583:Jejunum / Q000033:anatomy & histology* / Q000502:physiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008351:Mannans / Q000008:administration & dosage; D008353:Mannitol / Q000008:administration & dosage; D008875:Middle Aged; D053149:Plant Gums; D013012:Sorbitol / Q000008:administration & dosage; D014867:Water / Q000008:administration & dosage
D003287:Contrast Media; D005685:Galactans; D008351:Mannans; D053149:Plant Gums; D014867:Water; D008353:Mannitol; D013012:Sorbitol; C017471:locust bean gum