High-density oral barium sulfate in abdominal MRI: efficacy and tolerance in a clinical setting

Bowel and anatomic delineation were evaluated on abdominal magnetic resonance imaging scans in patients who received high-density barium sulfate orally (n = 16, BA+ group) or underwent magnetic resonance imaging without oral contrast (n = 14, BA- group). On T1-weighted images, the BA+ group had better delineation of gastric fundus, duodenum, jejunum, and ileum (p < .005) and pancreatic head (p < .02) than did the BA- group. On T2-weighted images, gastric fundus (p < .005), jejunum (p < .02), and ileum (p < .02) were better delineated in the BA+ group than in the BA- group. Analysis of patients' prior CT scans, used to control for selection bias, showed no differences in anatomic or bowel delineation between BA+ and BA- groups that would account for the differences seen in magnetic resonance imaging. One-fourth of patients could tolerate only 150 cc of contrast. High-density oral barium sulfate is recommended in patients undergoing magnetic resonance imaging for pancreatic or gastrointestinal tract disease, although patient intolerance may limit its widespread use in abdominal magnetic resonance imaging.