ferric-ammonium-citrate and Pancreatic-Diseases

The high signal intensity from the intestinal fluid usually deteriorates the projection images of MR cholangiopancreatography (MRCP) because it superimposes on the biliary tract. FerriSeltz (Otsuka pharmaceutical, Tokushima, Japan; a ferric ammonium citrate-based positive oral contrast agent) solution in a twelve fold higher concentration has a significant T2 shortening effect and could be used as a negative contrast agent suppressing the signal from intestinal fluid. Recently, we developed a new method named as "Dual Contrast MRCP" with intermediately concentrated FerriSeltz solution. This method provides MRCP both with and without duodenal image depending on TE length and is worth while screening of duodenal lesion even in a case with a small mount of duodenal fluid.

Topics: Artifacts; Biliary Tract Diseases; Body Fluids; Clinical Trials as Topic; Contrast Media; Duodenum; Ferric Compounds; Humans; Image Enhancement; Magnetic Resonance Imaging; Pancreatic Diseases; Quaternary Ammonium Compounds

To evaluate the efficacy and safety of two dose levels of an orally administered ferric ammonium citrate-based contrast agent for bowel enhancement on T1-weighted spin-echo magnetic resonance (MR) images in 222 patients with known or suspected abnormality of the upper abdomen.. Adverse reactions were graded for intensity, frequency, duration, and relationship to the contrast agent. Twelve unblinded readers compared enhanced with unenhanced images; all MR images were evaluated by two independent offsite radiologists in a blinded review.. No statistically significant changes in mean vital signs or laboratory values were seen. Forty-eight of 220 patients (22%) reported minor side effects. The readers found increased intraluminal signal intensity and improved contrast enhancement of the gastrointestinal tract and distention and improved signal homogeneity in 101-107 cases (89%-98%) after ingestion; the blinded reviewers' findings were similar.. The contrast agent provided new or additional radiologic information in 142 patients (64%), specific additional information in a detected abnormality in 46 of 142 patients (32%), and information that changed diagnosis, management, or surgical approach in 22 of 142 patients (15%).

Topics: Abdomen; Abdominal Neoplasms; Adolescent; Adult; Aged; Aged, 80 and over; Contrast Media; Digestive System Diseases; Dose-Response Relationship, Drug; Drug Tolerance; Female; Ferric Compounds; Humans; Image Enhancement; Intestines; Magnetic Resonance Imaging; Male; Middle Aged; Pancreatic Diseases; Quaternary Ammonium Compounds; Safety

The aim of this study was to compare prospectively the image quality of magnetic resonance cholangiopancreatography (MRCP) using manganese chloride tetrahydrate (Bothdel Oral Solution 10) (MCT), a new negative oral contrast agent; ferric ammonium citrate (FerriSeltz powder 20%) (FAC); and no agent.. MRCP images (TE 970 ms) of patients administered MCT (n = 19) or FAC (n = 20) at random, and 18 patients without an agent were evaluated. The subjective image quality of the overall, extrahepatic bile duct, and pancreatic duct and the degree of elimination of gastrointestinal fluid scored by two radiologists blinded to information regarding the agent were compared using Mann-Whitney's U-test.. The degrees of elimination of gastroduodenal fluid of MCT and FAC were significantly better than those without an agent (P < 0.01 and P < 0.01). The subjective image quality of MCT of the overall and extrahepatic bile duct were significantly better, although no significant differences for FAC were observed compared with those without an agent (P < 0.01 and P = 0.21, P = 0.02 and P = 0.16). There were no significant differences for the pancreatic duct (P = 0.12 and P = 0.19), nor were there any significant differences in the evaluations between MCT and FAC (P = 0.19-0.98).. MCT has shown performance comparable to that of conventional FAC in terms of pancreatic and biliary depiction and safety.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Bile Ducts; Biliary Tract Diseases; Chlorides; Cholangiopancreatography, Magnetic Resonance; Contrast Media; Female; Ferric Compounds; Humans; Image Enhancement; Male; Manganese Compounds; Middle Aged; Observer Variation; Pancreatic Diseases; Pancreatic Ducts; Prospective Studies; Quaternary Ammonium Compounds

We assessed the frequency of common bile duct (CBD) motion artifacts caused by inferior vena cava (IVC) pulsation on magnetic resonance cholangiopancreatography (MRCP).. We retrospectively evaluated CBD motion artifacts in 4 MRCP sequences from each of 115 consecutive patients.. We observed 37 (32.2%) ghost artifacts at the ventral and dorsal aspects of the CBD on transaxial, half-Fourier acquisition single-shot turbo spin-echo (HASTE-ax) images; no such artifacts were observed on transaxial T(2)-weighted turbo spin-echo images. In 10 patients, we observed 9 (7.8%) pseudo-defects of the CBD on 3-dimensional T(2)-weighted turbo spin-echo with navigator-triggered prospective acquisition correction technique MRCP and 6 (5.2%) pseudo-defects on single-shot rapid acquisition with relaxation enhancement MRCP. Pseudo-defects were significantly more frequent in patients with ghost artifacts than without (9 of 37 [24.3%] versus one of 78 [1.3%]; P<0.01, McNemar test).. Although uncommon, pseudo-defects of the CBD caused by IVC pulsation are observed on MRCP. MRCP interpretation that includes comparison with HASTE-ax images can diminish the potential misinterpretation of such CBD motion artifact as bile duct tumor or biliary stone.

Topics: Adult; Aged; Aged, 80 and over; Artifacts; Biliary Tract Diseases; Cholangiopancreatography, Magnetic Resonance; Common Bile Duct; Contrast Media; Female; Ferric Compounds; Fourier Analysis; Humans; Image Enhancement; Imaging, Three-Dimensional; Male; Middle Aged; Motion; Observer Variation; Pancreatic Diseases; Pulsatile Flow; Retrospective Studies; Vena Cava, Inferior