Gadopentetate dimeglumine as an oral negative gastrointestinal contrast agent for MRCP

Chan, J. H. M.; Tsui, Edmund; Yuen, Ming Keung; Szeto, Ming-Leung; Luk, S H; Wong, K.P.C.; Wong, Nicodemus

doi:10.1007/s002610000018

Cited by 37 publications

(36 citation statements)

References 12 publications

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“…As regards the pharmacological strategy utilizing oral ranitidine, the results of the present study were not similar to those reported by a previous study (5) . No significant difference was observed as regards reduction in signal between scans performed after fasting and after ingestion of 300 mg ranitidine.…”

Section: Discussioncontrasting

confidence: 56%

“…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.…”

Section: Discussionmentioning

confidence: 99%

“…2013 Mar/Abr;46(2):75-82 can be superimposed over the biliopancreatic tree, limiting the diagnostic quality of the method (4) . The signal from the gastrointestinal fluid may be abolished or reduced by three strategies as follows: prolonged fasting; intake of a negative oral contrast agent (5) ; or by means of reduction of gastric secretion with pharmaceuticals (6) . Negative contrast agents are paramagnetic solutions which promote reduction in signal intensity of the gastrointestinal fluid for shortening the T2 relaxation time at the magnetic resonance imaging (MRI).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2013

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Objective: To assess the impact of oral ranitidine on the imaging quality in magnetic resonance cholangiopancreatography (MRCP). Materials and Methods: Thirty-two patients underwent MRCP with 3D and 2D acquisitions, and three strategies for suppression of the gastrointestinal fluid signal: a) only at fasting; b) 12 hours after ingestion of 300 mg ranitidine; c) after oral administration of gadolinium solution. Three observers reviewed the images with a focus on the degree of visualization of the biliopancreatic tree. The interobserver agreement was evaluated with the kappa test. The difference between techniques and acquisition modalities were evaluated by means of average grading scores. Results: The three strategies for suppression of the gastrointestinal fluid signal presented high reproducibility. The results with suppression of the gastrointestinal fluid signal with ranitidine where similar to those obtained with fasting, and both were worse than those obtained with gadolinium solution. The 3D acquisitions surpassed 2D only in terms of visibility of the cystic duct and gallbladder, and were inferior or equivalent in the other biliopancreatic ductal segments. Conclusion: The use of ranitidine does not seem justified in the evaluation of the biliopancreatic tree at MRCP, since 2D MRCP with fasting allows the visualization of ductal structures with high quality and reproducibility in the majority of cases. Keywords: Ranitidine; Diagnostic use; Magnetic resonance cholangiopancreatography; Contrast media; Bile ducts; Pancreatic ducts.Objetivo: Avaliar o impacto da ranitidina por via oral na qualidade do exame de colangiopancreatografia por ressonân-cia magnética (CPRM). Materiais e Métodos: Trinta e dois pacientes realizaram CPRM com aquisições 3D e 2D, com três estratégias de supressão do sinal líquido gastrintestinal: a) apenas em jejum; b) 12 horas após ingerir 300 mg de ranitidina; c) após a ingestão de solução de gadolínio. Três observadores avaliaram os estudos, atentos para o grau de visualização da árvore biliopancreática. Foi medida a concordância interobservador com o teste kappa. A diferença entre técnicas e formas de aquisição foi avaliada pela média da soma dos escores de graduação. Resultados: As três estratégias de supressão do sinal líquido gastrintestinal apresentaram elevada reprodutibilidade. A supressão do sinal líquido gastrintestinal com a ranitidina foi semelhante ao jejum e ambas foram piores do que a solução de gadolínio. As aquisições 3D superaram a 2D apenas na visualização do ducto cístico e da vesícula biliar, sendo inferior ou equivalente nos demais segmentos ductais biliopancreáticos. Conclusão: O uso da ranitidina não parece justificado para aprimorar a avaliação da árvore biliopancreática em exames de CPRM. A CPRM 2D apenas em jejum permite a visualização ductal com elevada qualidade e reprodutibilidade na maioria dos casos. Unitermos: Ranitidina; Uso diagnóstico; Colangiopancreatografia por ressonância magnética; Meios de contraste; Ductos biliares; Ductos pancreáticos. Abstract...

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2013

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“…The gadopentetate dimeglumine was chosen due to its safety for oral administration, which has been demonstrated [32][33][34][35].…”

Section: Discussionmentioning

confidence: 99%

Use of pineapple juice with gadopentetate dimeglumine as a negative oral contrast for magnetic resonance cholangiopancreatography: a multicentric study

2011

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We evaluated the efficacy of pineapple juice with gadopentetate dimeglumine as a negative oral contrast agent for magnetic resonance cholangiopancreatography (MRCP). Images were obtained before and after the intake of a negative oral contrast agent. Images obtained from six different areas of the biliary tree were analyzed by three different radiologists, who were blind to the exams; scores regarding image quality were given to each area. The statistical analysis showed a significant difference between images before and after the use of the contrast agent (P < 0.001) for the three radiologists (R1-R3). Mean scores given by radiologists before the intake of the contrast agent were 2.49 ± 0.42 (R1), 2.62 ± 0.32 (R2), and 2.22 ± 0.46 (R3). After the intake, mean scores were 3.38 ± 0.62 (R1), 3.48 ± 0.55 (R2), and 2.89 ± 0.69 (R3). The ducts that showed the highest scores were the common bile duct and duct of Wirsung, the distal portion of the common bile duct and the cystic duct. We suggest herein that the contrast agent pineapple juice with gadopentate dimeglumine constitutes an efficient negative oral contrast agent for MRCP, for it efficiently eliminates the signal of the digestive tube in MRCP images.

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“…However, because of limited contrast resolution and relative inability to show the anastomotic site, CT correctly identifies the site of biliary obstruction in 10% of patients only [2,16] . The main role for CT is then to assess HAT [19] and/or detect intra-and extra-hepatic hypoattenuating collections when a suspicious biloma has gadolinium chelate contrast agent just before the acquisition of MRC in order to suppress overlapping fluid signal from the stomach and/or duodenum with paramagnetic effects on the T2 relaxation time [23] . However, because of the risk to mask the vaterian region of the common bile duct as a possible site of BC, the use of oral negative contrast agent is a matter of expertise and institutional preferences.…”

Section: Diagnostic Approach To Biliary Complicationsmentioning

confidence: 99%

Magnetic resonance cholangiography in the assessment and management of biliary complications after OLT

Girometti

Cereser

Bazzocchi

et al. 2014

WJR

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Core tip:The review is focused on three main topics, in order to emphasize why magnetic resonance cholangiography (MRC) is the preferred imaging modality to noninvasively assess the biliary system after orthotopic liver transplantation. First, the authors describe the different techniques that can be used, namely conventional MRC and contrast-enhanced MRC. Second, exemplificative imaging findings are illustrated in order to show the diagnostic reliability of the technique. Third, the Authors discuss the state-of-the-art role for MRC in assessing biliary complications as emerging from updated literature review. INTRODUCTIONDespite improvements in organ preservation, surgical technique, immunosuppression and postoperative management, biliary complications (BC) still represent the "Achille's heel" of orthotopic liver transplantation (OLT),

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Gadopentetate dimeglumine as an oral negative gastrointestinal contrast agent for MRCP

Abstract: Diluted intravenous MR contrast agent can be an effective and safe oral negative contrast agent in eliminating signal intensity of the gastrointestinal tract, thus improving the depiction of the biliary system in MRCP.

Cited by 37 publications

References 12 publications

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

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

Use of pineapple juice with gadopentetate dimeglumine as a negative oral contrast for magnetic resonance cholangiopancreatography: a multicentric study

Magnetic resonance cholangiography in the assessment and management of biliary complications after OLT

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