Development and Evaluation of a Novel Contrast Medium Suitable for Conventional Enteroclysis, Mr Enteroclysis and Virtual Mr Enteroscopy.

1199 Words Jan 30th, 2015 5 Pages
Abstract
The aim of this study was to develop and evaluate a gadolinium - barium sulfate solution for use in both conventional and MR enteroclysis. Eighteen vials of 20% barium sulfate and various gadolinium concentrations (lower 2.5 ml/lt, higher 45 ml/lt) were prepared and placed in the magnet. The imaging protocol was consisted of the following sequences: true FISP, HASTE with fat saturation and 3d FLASH with fat saturation in various flip angles. The lowest gadolinium concentration in the barium sulfate solution generating low intraluminal signal on HASTE and high intraluminal signal on true FISP and 3d FLASH sequences was 15 ml/lt. Ten patients underwent conventional enteroclysis with 1.5 lt of 20% barium sulfate enema and 22.5 ml of
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The use of the above contrast agent allows the performance of both examinations in the same session. Materials and methods
Phantom Study
Contrast Agent Optimization
Eighteen vials of 20% barium sulfate with various gadolinium concentrations (0, 2.5, 4, 5, 7.5, 10, 12.5, 15, 17.5, 20, 22.5, 25, 27.5, 30, 32.5, 35, 40 and 45 ml/lt), one vial with iso-osmotic water solution and one vial with taped water were prepared and placed in the magnet. Signal intensity measurements were performed in all sequences by placing a region of interest (ROI) in each vial for true FISP sequence, 3d FLASH with fat saturation in various flip angles (10, 20, 30, 40 and 45 degrees) and HASTE with fat saturation (major sequence parameters are shown in table 1). The optimal gadolinium concentration was determined by the degree of signal intensity reduction in HASTE sequence and the degree of signal intensity increase in the 3d FLASH and true FISP sequences. Signal intensity values were plotted against gadolinium concentrations for the HASTE and true FISP sequences while for the 3d FLASH sequence the same plots were generated for various flip angles.
Clinical Study
Patients
Ten consecutive patients (5 males and 5 females range 18-64 years, mean 46.2 years) underwent conventional and MR enteroclysis for suspected small bowel disease (n=6) or follow up of known Crohn's disease (n=4).

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