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Intraluminal contrast enhancement and MR visualization of the bowel wall: efficacy of PFOB
D L Rubin1, H H Muller, M Nino-Murcia
1Department of Diagnostic Radiology and Nuclear Medicine, Stanford University Medical Center, CA 94305.
Abstract:
Efforts to develop satisfactory intraluminal gastrointestinal contrast agents for magnetic resonance (MR) imaging have focused on depicting only the bowel lumen to exclude possible involvement by a pathologic process. To determine whether the bowel wall can be adequately imaged with use of the contrast agent and whether bowel wall visualization is a better index of the utility of the contrast agent for MR imaging, perfluoroocytlbromide (PFOB) was studied in human subjects. Twenty consecutive patients referred for abdominal or pelvic MR imaging were selected. All patients were given 400-1,000 mL of PFOB orally. MR imaging was performed at 0.38 and 1.5 T with T1- and T2-weighted spin-echo pulse sequences before and after administration of PFOB. The images were graded independently by three blinded readers. All readers reported significantly superior conspicuity of the bowel lumen and wall after PFOB than before PFOB administration (P less than .002). Among the post-PFOB studies, those with superior bowel wall visualization demonstrated superior overall image quality. In three patients, lesions were optimally demonstrated because the relationship of the process to the bowel wall, rather than just to the lumen, was identified. In two patients, masses arising within the bowel wall could be identified prospectively only when the bowel wall was adequately imaged. The authors conclude that while lumen identification is improved with PFOB, its greatest clinical utility may be in facilitating intestinal wall visualization.
Insights
Perfluoroocytlbromide (PFOB) significantly improves magnetic resonance (MR) imaging of the bowel lumen and wall. Enhanced bowel wall visualization with PFOB may offer greater clinical utility for diagnosing gastrointestinal conditions.
Area of Science:
- Gastrointestinal imaging
- Magnetic Resonance Imaging (MRI)
- Medical contrast agents
Background:
- Traditional gastrointestinal contrast agents for MRI primarily focus on visualizing the bowel lumen.
- Assessing bowel wall involvement in pathologies is crucial for accurate diagnosis.
Purpose of the Study:
- To evaluate the efficacy of perfluoroocytlbromide (PFOB) as an oral contrast agent for MR imaging.
- To determine if PFOB enhances bowel wall visualization and if this improves diagnostic utility.
Main Methods:
- Twenty patients undergoing abdominal/pelvic MR imaging received 400-1,000 mL of PFOB orally.
- MR imaging was performed at 0.38 T and 1.5 T using T1- and T2-weighted spin-echo sequences before and after PFOB administration.
- Images were independently graded by three blinded readers.
Main Results:
- PFOB administration significantly improved the conspicuity of both the bowel lumen and wall compared to pre-administration scans (P < .002).
- Studies with superior bowel wall visualization after PFOB showed better overall image quality.
- PFOB facilitated the identification of lesions and masses related to the bowel wall in several patients.
Conclusions:
- Perfluoroocytlbromide (PFOB) enhances both bowel lumen and wall visualization in MR imaging.
- The primary clinical benefit of PFOB may lie in its ability to improve intestinal wall imaging, aiding in the detection of intraluminal and intramural pathologies.