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Pineapple juice as a negative oral contrast agent in magnetic resonance cholangiopancreatography: a preliminary evaluation

Department of Radiology, Royal Cornwall Hospital, Truro, Cornwall TR1 3LJ, UK

View larger version (20K): [in a new window]   Figure 1. "Contrast agents" – orange juice (OJ), grapefruit juice (GJ), apple juice (AJ), pineapple juice (PJ), milk (M), prune juice (P), cranberry juice (CJ), blueberry and apple juice (BAJ), barium EZ Cat 2% w/v (B), dilute barium (50:50 with water) (DB), concentrated gastrografin (GG), ferumoxsil (F) and water (W).

View larger version (76K): [in a new window]   Figure 2. 2D MIXED Mode Sequence. Consisting of a multiple–echo spin echo sequence interleaved with a multiecho inversion recovery sequence, to provide single slice images [12].

View larger version (38K): [in a new window]   Figure 3. Single shot magnetic resonance cholangiopancreatography radial sequence (TR 8000 ms; TE 800 ms; flip angle 90°; echo spacing 7.8 ms; 5 radial sections of 40 mm thickness obtained at 12 degrees of rotation).

View larger version (29K): [in a new window]   Figure 4. Graph of T2 weighted (T2W) relative signal intensities/signal to noise ratio (SNR) of oral contrast agents. Orange juice (OJ), grapefruit juice (GJ), apple juice (AJ), pineapple juice (PJ), milk (M), prune juice (P), cranberry juice (CJ), blueberry and apple juice (BAJ), barium EZ Cat 2% w/v (B), dilute barium (50:50 with water) (DB), concentrated gastrografin (GG), ferumoxsil (F) and water (W).

View larger version (26K): [in a new window]   Figure 5. Graph of T1 weighted (T1W) relative signal intensities/signal to noise ratio (SNR) of oral contrast agents. Orange juice (OJ), grapefruit juice (GJ), apple juice (AJ), pineapple juice (PJ), milk (M), prune juice (P), cranberry juice (CJ), blueberry and apple juice (BAJ), barium EZ Cat 2% w/v (B), dilute barium (50:50 with water) (DB), concentrated gastrografin (GG), ferumoxsil (F) and water (W).

View larger version (29K): [in a new window]   Figure 6. Graph of single shot magnetic resonance cholangiopancreatography (SSH MRCP) radial relative signal intensities/signal to noise ratio (SNR) of oral contrast agents. Orange juice (OJ), grapefruit juice (GJ), apple juice (AJ), pineapple juice (PJ), milk (M), prune juice (P), cranberry juice (CJ), blueberry and apple juice (BAJ), barium EZ Cat 2% w/v (B), dilute barium (50:50 with water) (DB), concentrated gastrografin (GG), ferumoxsil (F) and water (W).

View larger version (16K): [in a new window]   Figure 7. T1/T2 relaxation times. Orange juice (OJ), grapefruit juice (GJ), apple juice (AJ), pineapple juice (PJ), milk (M), prune juice (P), cranberry juice (CJ), blueberry and apple juice (BAJ), barium EZ Cat 2% w/v (B), dilute barium (50:50 with water) (DB), concentrated gastrografin (GG), ferumoxsil (F) and water (W).

View larger version (14K): [in a new window]   Figure 8. Comparison of mean contrast effect scores (with standard errors) between pre and post (15 min and 30 min) pineapple juice (PJ) images.

View larger version (22K): [in a new window]   Figure 9. Comparison of mean image effect scores (with standard errors) between pre and post (15 min and 30 min) pineapple juice (PJ) images. Gall bladder (GB), intrahepatic ducts (IHD), common hepatic ducts (CHD), common bile duct (CBD), ampulla (A), pancreatic duct (in its entirety) (PD), pancreatic head duct (PH), pancreatic body duct (PB), pancreatic tail duct (PT).

View larger version (64K): [in a new window]   Figure 10. (a) Pre and (b) 15 min and (c) 30 min post pineapple juice (PJ) magnetic resonance cholangiopancreatography (MRCP) images. In (a) the middle portion of the common bile duct and body and tail of the pancreatic duct are not clear due to high signal in the duodenal cap and stomach. In (b) and (c) the high signal in the stomach and duodenum are eliminated almost completely, and the whole pancreaticobiliary structure is clearly visualized. (Note the incidental hepatic cysts).