Ces radiol. 2009, 63(3):210-216

MR enterography using experimental SPIO oral contrast agent - first experiencesOriginal article

Marková Ingrid^1,5, Kluchová Kateřina^2,3, Izák Niko¹, Novák Pavel⁴, Novotná Kateřina¹, Bielik Radoslav¹

¹ Radiologické oddelenie, FNsP F. D. Roosevelta, Banská Bystrica, Slovenská republika

² Výzkumné centrum nanomateriálů, UP Olomouc

³ Katedra fyzikálnej chémie, UP Olomouc

⁴ MEDIHOPE s.r.o., Prostějov

⁵ Rádiologická klinika LF a FNsP, UP Olomouc

Aim: Magnetic resonance is a method of choice in small bowel imaging according to high resolution of soft tissue, multiplanar acquisition, possibility of functional studies, absence of radiation, especially in children and younger population. From technical point of view small bowel preparation is necessary - sufficient distension, avoiding of motion artifacts, acceptable examination time. Small bowel distension can be reached in 2 ways, peroral filling or fillling through nasojejunal tube. Oral contrast agents are characterized as positive, negative or biphasic.

Method: Study is divided into 3 groups. There are 17 healthy volunteers in the first group. After 6-8 hours of fasting, they drank fractionally 1000 ml peroral solution within 50 minutes. Then followed MREg (magnetic resonance enterography) without intravenous contrast agent and spasmolytic agent. Second group was realized in 24 patients with MRCP (magnetic resonance pancreatico-cholangiography) with various diagnoses, as small bowel preparation we gave them 500 ml of peroral solution fractionally within 30 minutes. Last group consists of patients with Crohn's disease, inflammatory bowel disease, etc, study is not finished yet. All examinations were realized on 1,5T system (Signa Horizon Lx, GE, Milwaukee, Wisconsin, USA), examination protocol in MREg: breathhold axial/coronal plane 2D T2 SSFSE (single-shot fast spine-scho), all patients and volunteers fulfilled questionnaire about the solution characterization, 4 radiologists independently evaluated the examinations in first two groups. Third group was not statistically analyzed because of it is not finished yet. Analysis was made by statistic methods of χ²-test of good agreement and contingent tables with level of significance 5%.

Results: Evaluation of the questionnaires about solution characterization in first and second group resulted in existence of dependence on solution taste and appearance, fruity taste is connected with sufficient appearance and good solution taste, metalic and synthetic taste is connected with bad appearance and not good solution taste. According to statistic analysis, there is dependence between problems during drinking (diarrhoe, nausea, flatulence and gargoism) and problems remaining 2 hours after drinking solution. There was seen dependance between metalic, synthetic solution taste, associated nausea respectively. Adverse effects during drinking and after 2 hours drinking (diarrhoe, nausea, flatulence and gargoism) were present in both groups in dependance of solution taste and volume. Evaluation of MREg, MRCP, T2 weighted images is dependend on quality of luminal filling according to statistical analysis and 4 radiologists evaluation of first and second group. In 95% all 4 radiologists were agreed in answers for questions. Based on evalution of the questionnaires, 800 mg maghemit/4 g bentonit in 1000 ml of solution is sufficient concentration.

Conclusion: Oral contrast agent with SPIO nanoparticles of maghemit (800 mg) in bentonit matrix in 1000 ml solution, is appropriate for small bowel examination with MREg. Further study will be necessary for evaluation of inflammatory bowel diseases and MREg with SPIO oral contrast agent.

Keywords: magnetic resonance enterography (MREg), oral contrast agent, small bowel, SPIO (Super Paramagnetic Iron Oxides) particles

Grants and funding:

Článok vznikol v rámci grantového projektu CEP 1MO5512 Centrum práškových nanomateriálu na výzkumu SPIO perorální kontrastní látky při vyšetření tenkého střeva.

Accepted: August 15, 2009; Published: September 1, 2009  Show citation