title: Contrast enhanced magnetic resonance imaging as a diagnostic tool to assess bladder permeability and associated colon cross talk: preclinical studies in a rat model.
abstract: OBJECTIVE
  Interstitial cystitis/painful bladder syndrome is a devastating disease associated with multiple symptoms. It is usually diagnosed based on pain, urgency and frequency in the absence of other known causes. To our knowledge there is no diagnostic test to date.
  
  
  METHODS
  In a model of rats intravesically exposed to protamine sulfate we performed in vivo diagnostic contrast enhanced magnetic resonance imaging with intravesical administration of Gd-diethylenetriamine pentaacetic acid contrast medium via a catheter to visualize increased bladder urothelium permeability. Gd-diethylenetriamine pentaacetic acid was administered intravenously to visualize secondary tissue effects in the colon.
  
  
  RESULTS
  Bladder urothelium and colon mucosa were assessed 24 hours after bladder protamine sulfate exposure. Enhanced contrast magnetic resonance imaging established bladder urothelium leakage of Gd-diethylenetriamine pentaacetic acid according to the change in magnetic resonance imaging signal intensity in rats exposed to protamine sulfate vs controls (mean ± SD 399.7% ± 68.7% vs 39.2% ± 12.2%, p < 0.0001) as well as colon related uptake of contrast agent (mean 65.2% ± 17.1% vs 20.8% ± 9.8%, p < 0.01) after bladder protamine sulfate exposure. The kinetics of Gd-diethylenetriamine pentaacetic acid uptake and excretion were also assessed during 20 minutes of bladder and 30 minutes of colon exposure with increased signal intensity at 7 and 12 minutes, respectively.
  
  
  CONCLUSIONS
  These preliminary studies indicate that contrast enhanced magnetic resonance imaging can be used to monitor primary bladder urothelium loss of permeability and secondary enhanced contrast medium in the colon mucosa. It can be considered a potential clinical diagnostic method for interstitial cystitis/painful bladder syndrome that involves loss of the permeability barrier. It can also be used to assess visceral organ cross talk.
authors.affiliation: Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma. Electronic address: Rheal-Towner@omrf.org.
authors.forename: Rheal A
authors.initials: RA
authors.lastname: Towner
authors.affiliation: Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma.
authors.forename: Nataliya
authors.initials: N
authors.lastname: Smith
authors.affiliation: Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma.
authors.forename: Debra
authors.initials: D
authors.lastname: Saunders
authors.affiliation: Department of Urology, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma.
authors.forename: Samuel B
authors.initials: SB
authors.lastname: Van Gordon
authors.affiliation: Department of Urology, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma.
authors.forename: Amy B
authors.initials: AB
authors.lastname: Wisniewski
authors.affiliation: Department of Physiology, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma.
authors.forename: Karl R
authors.initials: KR
authors.lastname: Tyler
authors.affiliation: Department of Physiology, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma.
authors.forename: Beverley
authors.initials: B
authors.lastname: Greenwood-Van Meerveld
authors.affiliation: Department of Urology, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Hurst
mesh_terms: D000818:Animals; D003106:Colon / Q000502:physiology*; D003287:Contrast Media; D018856:Cystitis, Interstitial / Q000175:diagnosis*; D004195:Disease Models, Animal; D005260:Female; D008279:Magnetic Resonance Imaging / Q000379:methods*; D010539:Permeability; D051381:Rats; D017207:Rats, Sprague-Dawley; D001743:Urinary Bladder / Q000378:metabolism*
chemical_list: D003287:Contrast Media
keywords: colon; cystitis; diagnosis; interstitial; magnetic resonance imaging; urinary bladder