Use of carbon dioxide as negative contrast agent for magnetic resonance cholangiopancreatography

Abstract

AIM:To evaluate the effects of using CO2 as negative contrast agent in decreasing the overlapping on the pancreaticobiliary system from intestinal fluids. METHODS:We evaluated the magnetic resonance cholangiopancreatography (MRCP) images in 117 patients divided into two groups (group 1, without taking gas producing crystals to produce CO2, n = 64; group 2, with CO2, n = 53) in a 1.5T unit using MRCP sequence.Anatomic locations of intestinal fluids distribution, overlapping with common bile duct (CBD) and pancreatic duct (PD), were evaluated. RESULTS:In the group with CO2, the decrease in distribution of intestinal fluids was significant in the gastric antrum (P = 0.001) and duodenal bulb (P < 0.001), but not in the gastric fundus and body and in the second portion of the duodenum (P = 1.000, P = 0.171, and P = 0.584 respectively). In the group with CO2, the decrease in overlapping with CBD was significant (P < 0.001), but the decrease in overlapping with PD was not (P = 0.106).CONCLUSION: MRCP with carbon dioxide as negative contrast agent would decrease intestinal fluids in the gastric antrum and duodenal bulb, thereby decreasing overlapping with the CBD.

Efficacy of oral contrast agents for upper gastrointestinal signal suppression in MRCP: A systematic review of the literature

“…The shortest fasting period provided was 3 h ( 10 ), the longest was 12 h ( 11 ) with a median 6 h ( 12 – 16 ). The administered amount of contrast agent ranged from 10 mL ( 17 ) to 1000 mL ( 18 ); two articles did not supply any information on the administered amount of oral contrast ( 19 , 20 ). In most cases (n = 11), MRCP was performed immediately after the oral ingestion ( 11 , 17 – 27 ).…”

“…The administered amount of contrast agent ranged from 10 mL ( 17 ) to 1000 mL ( 18 ); two articles did not supply any information on the administered amount of oral contrast ( 19 , 20 ). In most cases (n = 11), MRCP was performed immediately after the oral ingestion ( 11 , 17 – 27 ). In all other cases (n = 14), time intervals between oral administration and the beginning of the scan ranged between 5 min ( 10 , 28 , 29 ) and 180 min ( 20 ).…”

“…The majority of publications (n = 18) studied MRCP protocols with and without the use of signal suppressors (certified products [n = 9] ( 9 , 10 , 16 – 18 , 21 , 25 , 26 , 30 ), fruit juices/beverages [n = 7] ( 11 , 13 – 15 , 21 , 28 , 29 ), pineapple juice in combination with non-absorbable gadolinium-chelate [n = 2] ( 22 , 24 ); Supplementary Table 1). Four compared certified agents to other products (fruit juices/beverages [n = 2] ( 21 , 31 ) or other certified agents [n = 2] ( 26 , 32 )).…”

“…Twenty-two publications studied MRCP in adult patients ( 9 – 14 , 16 – 33 ). Two studies investigated MRCP in pediatric patients ( 12 , 23 ).…”

Signal suppressions of grape syrup and grape syrup/lemon aqueous solutions in magnetic resonance cholangiopancreatography using heavily T2-weighted pulse sequence

“…The results of the study showed a decrease in the fluids of the antrum and the duodenal bulb, which in turn led to a decrease in the signal overlapping with the common bile duct. However, the tolerability of the bad smell and side effect of carbon dioxide made the patients uncomfortable [18].…”