Pineapple juice labeled with gadolinium: a convenient oral contrast for magnetic resonance cholangiopancreatography

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.

Choledocholithiasis: repetitive thick-slab single-shot projection magnetic resonance cholangiopancreaticography versus endoscopic ultrasonography

“…So far, there has not been any published consensus about the optimal MRCP technique for the investigation of choledocholithiasis [15,28]. In order to eliminate hyperintense gastric and duodenal content possibly overlapping the bile ducts, the administration of oral contrast and/or patient fasting has been recommended [12,16,22,31]. However, in our study we did not do such patient preparation.…”

“…Inter-observer agreement between the two radiologists for the detection of CBD stone disease was 0.81, therefore excellent according to the ratings of Fleiss [31]. Disagreement between the two readers occurred in five cases, among them two patients with CBD stones measuring 2 and 4 mm in diameter, respectively; therefore nonobstructive (one of them shown in Fig.…”

Accuracy of magnetic resonance cholangiography compared to operative endoscopy in detecting biliary stones, a single center experience and review of literature

“…A channelphased array body coil was used. Before the scan, pineapple juice, a negative oral contrast agent, was taken orally by all patients [12] . The scans were performed as follows: The first scan was T2/ TSE/HR: TR 3024, TE 115 Flip Angle 90° slices thickness 7 mm.…”

Papel da ranitidina como meio de aprimorar a qualidade do exame de colangiopancreatografia por ressonância magnética

“…In order to obtain such expected results, it is essential to assure a good imaging quality, which is expressed by the degree of ductal visualization (16) . The inappropriate characterization of the biliopancreatic tree ducts may originate from the presence of motion artifacts caused by peristaltic and respiratory movements and enteric fluid overlap (17) . In the present study, the authors have tried to demonstrate the results achieved in terms of ductal visualization at MRCP when different strategies are adopted, with the purpose of minimizing the superposition of gastrointestinal fluid over the biliary and pancreatic trees.…”

“…Some authors have put forward opinions which are based on their experience, rather than on hard evidences, indicating that the use oral contrast agent is not necessary (1) . On the other hand, others have demonstrated the usefulness of such a strategy to improve the visualization of the biliopancreatic tree (5,17) . It is important to notice that the latter have not utilized the radial sequence in the 2D breath-hold acquisitions, or have not performed the 3D sequences with RT in the routine evaluation of the biliopancreatic tree in their studies, contrarily to what was done in the present study, and which reduces the undesired superposition of the gastric juice with the biliopancreatic ducts.…”