title: Evaluation of date syrup as an oral negative contrast agent for MRCP.
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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 1 Department of Radiology, Mahatma Gandhi Medical College and Research Institute, Cuddalore Main Rd, Pillayarkuppam, Pondicherry, India 607402.
authors.forename: Arunkumar
authors.initials: A
authors.lastname: Govindarajan
authors.forename: Prakash Manikka
authors.initials: PM
authors.lastname: Lakshmanan
authors.forename: Radha
authors.initials: R
authors.lastname: Sarawagi
authors.forename: Velu
authors.initials: V
authors.lastname: Prabhakaran
mesh_terms: D000284:Administration, Oral; D001628:Beverages; D001652:Bile Ducts / Q000033:anatomy & histology*; D049448:Cholangiopancreatography, Magnetic Resonance / Q000295:instrumentation / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage; D005638:Fruit; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D010183:Pancreatic Ducts / Q000033:anatomy & histology*; D019047:Phantoms, Imaging; D065749:Phoeniceae / Q000737:chemistry*; D010936:Plant Extracts / Q000008:administration & dosage*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D010936:Plant Extracts
keywords: MRCP; date syrup; oral negative contrast agent