Abdominal Imaging

, Volume 37, Issue 3, pp 447–456 | Cite as

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

  • Juliana Avila Duarte
  • Alvaro Porto Alegre Furtado
  • Claudio Augusto Marroni


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.

Key words

MRI cholangiopancreatography Negative contrast media Pineapple juice Magnetic resonance imaging Liver 


  1. 1.
    Dooms GC, Fisher MR, Higgins CB, et al. (1986) MR imaging of the dilated biliary tract. Radiology 158(2):337–341PubMedGoogle Scholar
  2. 2.
    Wallner BK, Schumacher KA, Weidenmaier W, Friedrich JM (1991) Dilated biliary tract: evaluation with MR cholangiography with a T2-weighted contrast-enhanced fast sequence. Radiology 181(3):805–808PubMedGoogle Scholar
  3. 3.
    Morimoto K, Shimoi M, Shirakawa T, et al. (1992) Biliary obstruction: evaluation with three-dimensional MR cholangiography. Radiology 183(2):578–580PubMedGoogle Scholar
  4. 4.
    Schmidt S, Chevallier P, Novellas S, et al. (2007) Choledocholithiasis: repetitive thick-slab single-shot projection magnetic resonance cholangiopancreaticography versus endoscopic ultrasonography. Eur Radiol 17(1):241–250PubMedCrossRefGoogle Scholar
  5. 5.
    Pisani JC, Bacelar A, Malafaia O, et al. (2001) Comparative study between magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography in the diagnosis of the pancreatic and biliary obstruction. Arq Gastroenterol 38(3):149–157PubMedCrossRefGoogle Scholar
  6. 6.
    Vaishali MD, Agarwal AK, Upadhyaya DN, et al. (2004) Magnetic resonance cholangiopancreatography in obstructive jaundice. J Clin Gastroenterol 38(10):887–890PubMedCrossRefGoogle Scholar
  7. 7.
    Asbach P, Dewey M, Klessen C, et al. (2006) Respiratory-triggered MRCP applying parallel acquisition techniques. J Magn Reson Imaging 24(5):1095–1100PubMedCrossRefGoogle Scholar
  8. 8.
    Chan YL, Chan AC, Lam WW, et al. (1996) Choledocholithiasis: comparison of MR cholangiography and endoscopic retrograde cholangiography. Radiology 200(1):85–89PubMedGoogle Scholar
  9. 9.
    Fulcher AS, Turner MA, Capps GW, Zfass AM, Baker KM (1998) Half-Fourier RARE MR cholangiopancreatography: experience in 300 subjects. Radiology 207(1):21–32PubMedGoogle Scholar
  10. 10.
    Fulcher AS, Turner MA, Franklin KJ, et al. (2000) Primary sclerosing cholangitis: evaluation with MR cholangiography—a case–control study. Radiology 215(1):71–80PubMedGoogle Scholar
  11. 11.
    Soto JA, Barish MA, Ferrucci JT (1997) Magnetic resonance imaging of the bile ducts. Semin Roentgenol 32(3):188–201PubMedCrossRefGoogle Scholar
  12. 12.
    Calculli L, Pezzilli R, Fiscaletti M, et al. (2008) Exocrine pancreatic function assessed by secretin cholangio-Wirsung magnetic resonance imaging. Hepatobiliary Pancreat Dis Int 7(2):192–195PubMedGoogle Scholar
  13. 13.
    Bernardino ME, Weinreb JC, Mitchell DG, Small WC, Morris M (1994) Safety and optimum concentration of a manganese chloride-based oral MR contrast agent. J Magn Reson Imaging 4(6):872–876PubMedCrossRefGoogle Scholar
  14. 14.
    Pels Rijcken TH, Davis MA, Ros PR (1994) Intraluminal contrast agents for MR imaging of the abdomen and pelvis. J Magn Reson Imaging 4(3):291–300PubMedCrossRefGoogle Scholar
  15. 15.
    Bisset GS III, Strife JL, McCloskey J (1989) MR imaging of coronary artery aneurysms in a child with Kawasaki disease. AJR Am J Roentgenol 152(4):805–807PubMedGoogle Scholar
  16. 16.
    Saini S, Stark DD, Rzedzian RR, et al. (1989) Forty-millisecond MR imaging of the abdomen at 2.0 T. Radiology 173(1):111–116PubMedGoogle Scholar
  17. 17.
    Cory DA, Schwartzentruber DJ, Mock BH (1987) Ingested manganese chloride as a contrast agent for magnetic resonance imaging. Magn Reson Imaging 5(1):65–70PubMedCrossRefGoogle Scholar
  18. 18.
    Mitchell DG, Vinitski S, Mohamed FB, et al. (1991) Comparison of Kaopectate with barium for negative and positive enteric contrast at MR imaging. Radiology 181(2):475–480PubMedGoogle Scholar
  19. 19.
    Soto JA, Barish MA, Yucel EK, et al. (1996) Magnetic resonance cholangiography: comparison with endoscopic retrograde cholangiopancreatography. Gastroenterology 110(2):589–597PubMedCrossRefGoogle Scholar
  20. 20.
    Karantanas AH, Papanikolaou N, Kalef-Ezra J, Challa A, Gourtsoyiannis N (2000) Blueberry juice used per os in upper abdominal MR imaging: composition and initial clinical data. Eur Radiol 10(6):909–913PubMedCrossRefGoogle Scholar
  21. 21.
    Cordova-Fraga T, de Araujo DB, Sanchez TA, et al. (2004) Euterpe Oleracea (Acai) as an alternative oral contrast agent in MRI of the gastrointestinal system: preliminary results. Magn Reson Imaging 22(3):389–393PubMedCrossRefGoogle Scholar
  22. 22.
    Espinosa MG, Sosa M, De Leon-Rodriguez LM, et al. (2006) Blackberry (Rubus spp.): a pH-dependent oral contrast medium for gastrointestinal tract images by magnetic resonance imaging. Magn Reson Imaging 24(2):195–200PubMedCrossRefGoogle Scholar
  23. 23.
    Coppens E, Metens T, Winant C, Matos C (2005) Pineapple juice labeled with gadolinium: a convenient oral contrast for magnetic resonance cholangiopancreatography. Eur Radiol 15(10):2122–2129PubMedCrossRefGoogle Scholar
  24. 24.
    Ayuso JR, Ayuso C, Bombuy E, et al. (2004) Preoperative evaluation of biliary anatomy in adult live liver donors with volumetric mangafodipir trisodium enhanced magnetic resonance cholangiography. Liver Transpl 10(11):1391–1397PubMedCrossRefGoogle Scholar
  25. 25.
    Cavalcanti JS, Oliveira EdL, Santos LPF, et al. (2002) Estudo anatomotopográfico das vias biliares extra hepáticas e do trígono cistohepático. Acta Cirurgica Brasileira 17:30–35CrossRefGoogle Scholar
  26. 26.
    Hirohashi S, Hirohashi R, Uchida H, et al. (1997) MR cholangiopancreatography and MR urography: improved enhancement with a negative oral contrast agent. Radiology 203(1):281–285PubMedGoogle Scholar
  27. 27.
    Sirvanci M, Duran C, Ozturk E, et al. (2007) The value of magnetic resonance cholangiography in the preoperative assessment of living liver donors. Clin Imaging 31(6):401–405PubMedCrossRefGoogle Scholar
  28. 28.
    Hiraishi K, Narabayashi I, Fujita O, et al. (1995) Blueberry juice: preliminary evaluation as an oral contrast agent in gastrointestinal MR imaging. Radiology 194(1):119–123PubMedGoogle Scholar
  29. 29.
    Riordan RD, Khonsari M, Jeffries J, Maskell GF, Cook PG (2004) Pineapple juice as a negative oral contrast agent in magnetic resonance cholangiopancreatography: a preliminary evaluation. Br J Radiol 77(924):991–999PubMedCrossRefGoogle Scholar
  30. 30.
    Luboldt W, Kienzler D, Seemann M, et al. (2000) Synergistic effect between iron and gadolinium in MRI. J Magn Reson Imaging 12(2):358–362PubMedCrossRefGoogle Scholar
  31. 31.
    Watson AD, Rocklage SM, Carvlin MJ (1992) Contrast agents. In: Stark DD, Bradley WG (eds) MR imaging. Mosby, St LouisGoogle Scholar
  32. 32.
    Chan JH, Tsui EY, Yuen MK, et al. (2000) Gadopentetate dimeglumine as an oral negative gastrointestinal contrast agent for MRCP. Abdom Imaging 25(4):405–408PubMedCrossRefGoogle Scholar
  33. 33.
    Young SW, Qing F, Rubin D, et al. (1995) Gadolinium zeolite as an oral contrast agent for magnetic resonance imaging. J Magn Reson Imaging 5(5):499–508PubMedCrossRefGoogle Scholar
  34. 34.
    Rubin DL, Falk KL, Sperling MJ, et al. (1997) A multicenter clinical trial of Gadolite Oral Suspension as a contrast agent for MRI. J Magn Reson Imaging 7(5):865–872PubMedCrossRefGoogle Scholar
  35. 35.
    Kaminsky S, Laniado M, Gogoll M, et al. (1992) Oral contrast media for the magnetic resonance tomography of the abdomen. A clinical trial of the tolerance for gadolinium-DTPA. Rofo 156(1):17–23PubMedCrossRefGoogle Scholar
  36. 36.
    Schwizer W, Fraser R, Maecke H, et al. (1994) Gd-DOTA as a gastrointestinal contrast agent for gastric emptying measurements with MRI. Magn Reson Med 31(4):388–393PubMedCrossRefGoogle Scholar
  37. 37.
    Kunz P, Crelier GR, Schwizer W, et al. (1998) Gastric emptying and motility: assessment with MR imaging—preliminary observations. Radiology 207(1):33–40PubMedGoogle Scholar
  38. 38.
    Allard M, Doucet D, Kien P, Bonnemain B, Caille JM (1988) Experimental study of DOTA-gadolinium. Pharmacokinetics and pharmacologic properties. Invest Radiol 23(Suppl 1):S271–S274PubMedCrossRefGoogle Scholar
  39. 39.
    Patak MA, Weishaupt D, Frohlich JM, Debatin JF (1999) Sequential fast 3D MRI following oral ingestion of Gd-DOTA: a new means to assess intestinal transit time. J Magn Reson Imaging 10(3):474–476PubMedCrossRefGoogle Scholar
  40. 40.
    Schmid MR, Hany TF, Knesplova L, Schlumpf R, Debatin JF (1999) 3D MR gastrography: exoscopic and endoscopic analysis of the stomach. Eur Radiol 9(1):73–77PubMedCrossRefGoogle Scholar
  41. 41.
    Lauenstein TC, Goehde SC, Debatin JF (2002) Fecal tagging: MR colonography without colonic cleansing. Abdom Imaging 27(4):410–417PubMedCrossRefGoogle Scholar
  42. 42.
    Weinmann HJ, Brasch RC, Press WR, Wesbey GE (1984) Characteristics of gadolinium–DTPA complex: a potential NMR contrast agent. AJR Am J Roentgenol 142(3):619–624PubMedGoogle Scholar
  43. 43.
    Papanikolaou N, Karantanas A, Maris T, Gourtsoyiannis N (2000) MR cholangiopancreatography before and after oral blueberry juice administration. J Comput Assist Tomogr 24(2):229–234PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Juliana Avila Duarte
    • 1
    • 2
  • Alvaro Porto Alegre Furtado
    • 3
    • 4
  • Claudio Augusto Marroni
    • 5
  1. 1.Radiologia − Magnetic ResonanceHospital de Clínicas de Porto Alegre (HCPA)Porto AlegreBrazil
  2. 2. Magnetic ResonanceTomoclinicaCanoasBrazil
  3. 3.Department of RadiologyUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA)Porto AlegreBrazil
  4. 4.Department of RadiologyUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
  5. 5.Faculty of Medicine and Graduate Program in HepatologyUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA)Porto AlegreBrazil

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