Skip to main content
Top
Published in: European Radiology 3/2004

01-03-2004 | Gastrointestinal

Oral contrast agents for small bowel MRI: comparison of different additives to optimize bowel distension

Authors: Waleed Ajaj, Susanne C. Goehde, Hubert Schneemann, Stefan G. Ruehm, Jörg F. Debatin, Thomas C. Lauenstein

Published in: European Radiology | Issue 3/2004

Login to get access

Abstract

The purpose of this study was to compare two osmotic carbohydrate sugar alcohols (mannitol 2.5% and sorbitol 2.5%, 2.0%, and 1.5% watery solutions) in combination with 0.2% locust bean gum (LBG) for small bowel distension for MR imaging. Small bowel distension was quantified on coronal 2D TrueFISP images by measuring the diameters of 16 small bowel loops in each of 12 healthy subjects (age range 31–55 years). Additionally, the grade of small bowel distension was rated qualitatively. Patient acceptance concerning nausea, vomiting, flatulence, and diarrhea was noted for each solution, and all results were compared by a Wilcoxon test or t test, respectively. The ingestion of water combined with LBG and either 2.5% mannitol or 2.0% sorbitol showed the best distension of the small bowel. The lowest side effect rate was observed following ingestion of sorbitol in a concentration of 2.0 and 1.5%. Based on these data, we recommend a combination of LBG and 2% sorbitol use for optimal bowel distension and minimal side effects resulting in enhanced patient acceptance.
Literature
1.
go back to reference Lehmann FS (2003) Pathophysiology of inflammatory bowel disease. Ther Umsch 60:127–132PubMed Lehmann FS (2003) Pathophysiology of inflammatory bowel disease. Ther Umsch 60:127–132PubMed
2.
go back to reference Ochsenkuhn T, Sackmann M, Goke B (2003) Inflammatory bowel diseases (IBD): critical discussion of etiology, pathogenesis, diagnostics, and therapy. Radiologe 43:1–8PubMed Ochsenkuhn T, Sackmann M, Goke B (2003) Inflammatory bowel diseases (IBD): critical discussion of etiology, pathogenesis, diagnostics, and therapy. Radiologe 43:1–8PubMed
3.
go back to reference Shia J, Teruya-Feldstein J, Pan D, Hegde A, Klimstra DS, Chaganti RS, Qin J, Portlock CS, Filippa DA (2002) Primary follicular lymphoma of the gastrointestinal tract: a clinical and pathologic study of 26 cases. Am J Surg Pathol 26:216–224CrossRef Shia J, Teruya-Feldstein J, Pan D, Hegde A, Klimstra DS, Chaganti RS, Qin J, Portlock CS, Filippa DA (2002) Primary follicular lymphoma of the gastrointestinal tract: a clinical and pathologic study of 26 cases. Am J Surg Pathol 26:216–224CrossRef
4.
go back to reference Muneyuki T, Watanabe M, Yamanaka M, Isaji S, Kawarada Y, Yatani R (2000) Combination analysis of genetic alterations and cell proliferation in small intestinal carcinomas. Dig Dis Sci 45:2022–2028CrossRefPubMed Muneyuki T, Watanabe M, Yamanaka M, Isaji S, Kawarada Y, Yatani R (2000) Combination analysis of genetic alterations and cell proliferation in small intestinal carcinomas. Dig Dis Sci 45:2022–2028CrossRefPubMed
5.
go back to reference Maglinte DDT, Chernish SM, Kelvin FM et al. (1992) Crohn’s disease of the small intestine: accuracy and relevance of enteroclysis. Radiology 184:541–545PubMed Maglinte DDT, Chernish SM, Kelvin FM et al. (1992) Crohn’s disease of the small intestine: accuracy and relevance of enteroclysis. Radiology 184:541–545PubMed
6.
go back to reference Maglinte DD, Hall R, Miller RE, Chernish SM, Rosenak B, Elmore M, Burney BT (1984) Detection of surgical lesions of the small bowel by enteroclysis. Am J Surg 147:225–229PubMed Maglinte DD, Hall R, Miller RE, Chernish SM, Rosenak B, Elmore M, Burney BT (1984) Detection of surgical lesions of the small bowel by enteroclysis. Am J Surg 147:225–229PubMed
7.
go back to reference Umschaden HW, Szolar D, Gasser J, Umschaden M, Haselbach H (2000) Small-bowel disease: comparison of MR enteroclysis images with conventional enteroclysis and surgical findings. Radiology 215:717–725PubMed Umschaden HW, Szolar D, Gasser J, Umschaden M, Haselbach H (2000) Small-bowel disease: comparison of MR enteroclysis images with conventional enteroclysis and surgical findings. Radiology 215:717–725PubMed
8.
go back to reference Moch A, Herlinger H, Kochman ML, Levine MS, Rubesin SE, Laufer I (1994) Enteroclysis in the evaluation of obscure gastrointestinal bleeding. Am J Roentgenol 163:1381–1384 Moch A, Herlinger H, Kochman ML, Levine MS, Rubesin SE, Laufer I (1994) Enteroclysis in the evaluation of obscure gastrointestinal bleeding. Am J Roentgenol 163:1381–1384
9.
go back to reference Maglinte DD, Gage SN, Harmon BH, Kelvin FM, Hage JP, Chua GT, Ng AC, Graffis RF, Chernish SM (1993) Obstruction of the small intestine: accuracy and role of CT in diagnosis. Radiology 188:61–64PubMed Maglinte DD, Gage SN, Harmon BH, Kelvin FM, Hage JP, Chua GT, Ng AC, Graffis RF, Chernish SM (1993) Obstruction of the small intestine: accuracy and role of CT in diagnosis. Radiology 188:61–64PubMed
10.
go back to reference Thoeni RF, Gould RG (1991) Enteroclysis and small bowel series: comparison of radiation dose and examination time. Radiology 178:659–662PubMed Thoeni RF, Gould RG (1991) Enteroclysis and small bowel series: comparison of radiation dose and examination time. Radiology 178:659–662PubMed
11.
go back to reference van Gelder RE, Venema HW, Serlie IW, Nio CY, Determann RM, Tipker CA, Vos FM et al. (2002) CT colonography at different radiation dose levels: feasibility of dose reduction. Radiology 224:24–33 van Gelder RE, Venema HW, Serlie IW, Nio CY, Determann RM, Tipker CA, Vos FM et al. (2002) CT colonography at different radiation dose levels: feasibility of dose reduction. Radiology 224:24–33
12.
go back to reference Rieber A, Wruk D, Potthast S, Nussle K, Reinshagen M, Adler G, Brambs HJ (2000) Diagnostic imaging in Crohn’s disease: comparison of magnetic resonance imaging and conventional imaging methods. Int J Colorectal Dis 15:176–181PubMed Rieber A, Wruk D, Potthast S, Nussle K, Reinshagen M, Adler G, Brambs HJ (2000) Diagnostic imaging in Crohn’s disease: comparison of magnetic resonance imaging and conventional imaging methods. Int J Colorectal Dis 15:176–181PubMed
13.
go back to reference Lauenstein TC, Schneemann H, Vogt FM, Herborn CU, Ruhm SG, Debatin JF (2003) Optimization of oral contrast agents for MR imaging of the small bowel. Radiology Lauenstein TC, Schneemann H, Vogt FM, Herborn CU, Ruhm SG, Debatin JF (2003) Optimization of oral contrast agents for MR imaging of the small bowel. Radiology
14.
go back to reference Keighley MR, Lee JR, Ambrose NS (1983) Indications and techniques for bowel preparation in colorectal cancer. Int Adv Surg Oncol 6:257–270PubMed Keighley MR, Lee JR, Ambrose NS (1983) Indications and techniques for bowel preparation in colorectal cancer. Int Adv Surg Oncol 6:257–270PubMed
15.
go back to reference Avgerinos A, Kalantzis N, Rekoumis G, Pallikaris G, Arapakis G, Kanaghinis T (1984) Bowel preparation and the risk of explosion during colonoscopic polypectomy. Gut 25:361–364PubMed Avgerinos A, Kalantzis N, Rekoumis G, Pallikaris G, Arapakis G, Kanaghinis T (1984) Bowel preparation and the risk of explosion during colonoscopic polypectomy. Gut 25:361–364PubMed
16.
go back to reference Hänsel R, Sticher O, Steinegger E (1999) Pharmakognosie und Phytopharmazie. Springer, Berlin Heidelberg New York, pp 309–327 Hänsel R, Sticher O, Steinegger E (1999) Pharmakognosie und Phytopharmazie. Springer, Berlin Heidelberg New York, pp 309–327
17.
go back to reference Regand A, Goff HD (2002) Effect of biopolymers on structure and ice recrystallization in dynamically frozen ice cream model systems. J Dairy Sci 85:2722–2732PubMed Regand A, Goff HD (2002) Effect of biopolymers on structure and ice recrystallization in dynamically frozen ice cream model systems. J Dairy Sci 85:2722–2732PubMed
18.
go back to reference Schunk K, Kern A, Heussel CP, Kalden P, Orth T, Wanitschke R, Thelen M (1999) Hydro-MRT with fast sequences in Crohn’s disease: a comparison with fractionated gastrointestinal passage. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 170:338–346PubMed Schunk K, Kern A, Heussel CP, Kalden P, Orth T, Wanitschke R, Thelen M (1999) Hydro-MRT with fast sequences in Crohn’s disease: a comparison with fractionated gastrointestinal passage. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 170:338–346PubMed
19.
go back to reference Stacher G, Peeters TL, Bergmann H, Wiesnagrotzki S, Schneider C, Granser-Vacariu GV, Gaupmann G, Kugi A (1993) Erythromycin effects on gastric emptying, antral motility, and plasma motilin and pancreatic polypeptide concentrations in anorexia nervosa. Gut 34:166–172PubMed Stacher G, Peeters TL, Bergmann H, Wiesnagrotzki S, Schneider C, Granser-Vacariu GV, Gaupmann G, Kugi A (1993) Erythromycin effects on gastric emptying, antral motility, and plasma motilin and pancreatic polypeptide concentrations in anorexia nervosa. Gut 34:166–172PubMed
20.
go back to reference Nakabayashi T, Mochiki E, Kamiyama Y, Haga N, Asao T, Kuwano H (2003) Erythromycin induces pyloric relaxation accompanied by a contraction of the gastric body after pylorus-preserving gastrectomy. Surgery 133:647–655CrossRefPubMed Nakabayashi T, Mochiki E, Kamiyama Y, Haga N, Asao T, Kuwano H (2003) Erythromycin induces pyloric relaxation accompanied by a contraction of the gastric body after pylorus-preserving gastrectomy. Surgery 133:647–655CrossRefPubMed
21.
go back to reference Stehling MK, Holzknecht N, Gauger J, Luboldt W, Smekal A von, Laub G, Reiser M (1996) Gadolinium-enhanced magnetic resonance angiography with ultra-short echo times. Radiologe 36:670–675PubMed Stehling MK, Holzknecht N, Gauger J, Luboldt W, Smekal A von, Laub G, Reiser M (1996) Gadolinium-enhanced magnetic resonance angiography with ultra-short echo times. Radiologe 36:670–675PubMed
22.
go back to reference Quick HH, Ladd ME, Hoevel M, Bosk S, Debatin JF, Laub G, Schroeder T (2002) Real time MRI of joint movement with TrueFISP. J Magn Reson Imaging 15:710–715CrossRefPubMed Quick HH, Ladd ME, Hoevel M, Bosk S, Debatin JF, Laub G, Schroeder T (2002) Real time MRI of joint movement with TrueFISP. J Magn Reson Imaging 15:710–715CrossRefPubMed
23.
go back to reference Gourtsoyiannis N, Papanikolaou N, Grammatikakis J, Maris T, Prassopoulos P (2001) MR enteroclysis protocol optimization: comparison between 3D FLASH with fat saturation after intravenous gadolinium injection and TrueFISP sequences. Eur Radiol 908–913 Gourtsoyiannis N, Papanikolaou N, Grammatikakis J, Maris T, Prassopoulos P (2001) MR enteroclysis protocol optimization: comparison between 3D FLASH with fat saturation after intravenous gadolinium injection and TrueFISP sequences. Eur Radiol 908–913
24.
go back to reference Scheffler K, Hennig J (2003) Is TrueFISP a gradient-echo or a spin-echo sequence? Magn Reson Med 49:395–397CrossRefPubMed Scheffler K, Hennig J (2003) Is TrueFISP a gradient-echo or a spin-echo sequence? Magn Reson Med 49:395–397CrossRefPubMed
25.
go back to reference Herborn CU, Vogt F, Lauenstein TC, Goyen M, Debatin JF, Ruehm SG (2003) MRI of the liver: Can True FISP replace HASTE? J Magn Reson Imaging 17:190–196CrossRefPubMed Herborn CU, Vogt F, Lauenstein TC, Goyen M, Debatin JF, Ruehm SG (2003) MRI of the liver: Can True FISP replace HASTE? J Magn Reson Imaging 17:190–196CrossRefPubMed
26.
go back to reference Debatin JF, Patak MA (1999) MRI of the small and large bowel. Eur Radiol 9:1523–1534 Debatin JF, Patak MA (1999) MRI of the small and large bowel. Eur Radiol 9:1523–1534
27.
go back to reference Gourtsoyiannis N, Papanikolaou N, Grammatikakis J, Prassopoulos P (2002) MR enteroclysis: technical considerations and clinical applications. Eur Radiol 12:2651–2658PubMed Gourtsoyiannis N, Papanikolaou N, Grammatikakis J, Prassopoulos P (2002) MR enteroclysis: technical considerations and clinical applications. Eur Radiol 12:2651–2658PubMed
28.
go back to reference Schmidt S, Lepori D, Meuwly JY, Duvoisin B, Meuli R, Michetti P, Felley C, Schnyder P, van Melle G, Denys A (2003) Prospective comparison of MR enteroclysis with multidetector spiral-CT enteroclysis: interobserver agreement and sensitivity by means of “sign-by-sign” correlation. Eur Radiol 13:1303–1311PubMed Schmidt S, Lepori D, Meuwly JY, Duvoisin B, Meuli R, Michetti P, Felley C, Schnyder P, van Melle G, Denys A (2003) Prospective comparison of MR enteroclysis with multidetector spiral-CT enteroclysis: interobserver agreement and sensitivity by means of “sign-by-sign” correlation. Eur Radiol 13:1303–1311PubMed
29.
go back to reference Lomas DJ, Graves MJ (1999) Small bowel MRI using water as a contrast medium. Br J Radiol 72:994–997PubMed Lomas DJ, Graves MJ (1999) Small bowel MRI using water as a contrast medium. Br J Radiol 72:994–997PubMed
30.
go back to reference Patak MA, Froehlich JM, Weymarn C von, Ritz MA, Zollikofer CL, Wentz K (2001) Non-invasive distension of the small bowel for magnetic resonance imaging. Lancet 358:987–988PubMed Patak MA, Froehlich JM, Weymarn C von, Ritz MA, Zollikofer CL, Wentz K (2001) Non-invasive distension of the small bowel for magnetic resonance imaging. Lancet 358:987–988PubMed
31.
go back to reference Laghi A, Paolantonio P, Catalano C, Dito L, Carbone I, Barbato M, Tomei E, Passariello R (2003) MR imaging of the small bowel using polyethylene glycol solution as an oral contrast agent in adults and children with celiac disease: preliminary observations. Am J Roentgenol 180:191–194 Laghi A, Paolantonio P, Catalano C, Dito L, Carbone I, Barbato M, Tomei E, Passariello R (2003) MR imaging of the small bowel using polyethylene glycol solution as an oral contrast agent in adults and children with celiac disease: preliminary observations. Am J Roentgenol 180:191–194
32.
go back to reference Zanoni CE, Bergamini C, Bertoncini M, Bertoncini L, Garbini A (1982) Whole-gut lavage for surgery: a case of intraoperative colonic explosion after administration of mannitol. Dis Colon Rectum 25:580–581PubMed Zanoni CE, Bergamini C, Bertoncini M, Bertoncini L, Garbini A (1982) Whole-gut lavage for surgery: a case of intraoperative colonic explosion after administration of mannitol. Dis Colon Rectum 25:580–581PubMed
33.
go back to reference Bigard MA, Gaucher P, Lassalle C (1979) Fatal colonic explosion during colonoscopic polypectomy. Gastroenterology 77:1307–1310PubMed Bigard MA, Gaucher P, Lassalle C (1979) Fatal colonic explosion during colonoscopic polypectomy. Gastroenterology 77:1307–1310PubMed
34.
go back to reference La Brooy SJ, Avgerinos A, Fendick CL, Williams CB, Misiewicz JJ (1981) Potentially explosive colonic concentrations of hydrogen after bowel preparation with mannitol. Lancet 1:634–636PubMed La Brooy SJ, Avgerinos A, Fendick CL, Williams CB, Misiewicz JJ (1981) Potentially explosive colonic concentrations of hydrogen after bowel preparation with mannitol. Lancet 1:634–636PubMed
35.
go back to reference Maison S, Meunier J, Mialon G, Demolin P, Bret M, Bouletreau P, Brette R (1982) Unusual complication of colonic preparation with mannitol: hypovolemic collapse in a patient treated with beta-blockers. Gastroenterol Clin Biol 6:408PubMed Maison S, Meunier J, Mialon G, Demolin P, Bret M, Bouletreau P, Brette R (1982) Unusual complication of colonic preparation with mannitol: hypovolemic collapse in a patient treated with beta-blockers. Gastroenterol Clin Biol 6:408PubMed
36.
go back to reference Spring A (1980) Blood-level changes of lactate and pyruvate after osmotherapy with mannitol and sorbitol. Neurochirurgia 23:176–181PubMed Spring A (1980) Blood-level changes of lactate and pyruvate after osmotherapy with mannitol and sorbitol. Neurochirurgia 23:176–181PubMed
37.
go back to reference Wang YM, van Eys J (1981) Nutritional significance of fructose and sugar alcohols. Annu Rev Nutr 1:437–475CrossRefPubMed Wang YM, van Eys J (1981) Nutritional significance of fructose and sugar alcohols. Annu Rev Nutr 1:437–475CrossRefPubMed
Metadata
Title
Oral contrast agents for small bowel MRI: comparison of different additives to optimize bowel distension
Authors
Waleed Ajaj
Susanne C. Goehde
Hubert Schneemann
Stefan G. Ruehm
Jörg F. Debatin
Thomas C. Lauenstein
Publication date
01-03-2004
Publisher
Springer-Verlag
Published in
European Radiology / Issue 3/2004
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-003-2177-0

Other articles of this Issue 3/2004

European Radiology 3/2004 Go to the issue

Letter to the Editor

Letter to the Editor

Letter to the Editor

Letter to the Editor