Small bowel MRI: comparison of a polyethylene glycol preparation and water as oral contrast media

Abstract

Purpose: To compare water and a polyethylene glycol (PEG) preparation as potential oral contrast media for magnetic resonance imaging (MRI) of the small bowel.

Materials and methods: Twenty-two healthy volunteers underwent separate MRI examinations after drinking up to two liters of water or PEG preparation. Small bowel images were obtained every 10 minutes for at least two hours using breath-hold single shot half-Fourier imaging, including both thick section projection and thin section images. Examinations were evaluated by two radiologists in consensus, blinded to the volunteer and contrast details, for arrival at the terminal ileum, transit time, and demonstration of small bowel segments.

Results: The PEG preparation was significantly better than water at reaching the terminal ileum (PEG 21/22 volunteers [95.45%], water 14/22 volunteers [63.6%], P = 0.04). There was no significant difference in the mean transit time (water 51 +/- 48 minutes, PEG 37.7 +/- 22 minutes) or in the demonstration of the stomach, duodenum, and jejunum, but the PEG preparation was significantly better at demonstrating the ileum (P = 0.005) and terminal ileum (P = 0.002).

Conclusion: A PEG preparation is significantly better than water as an oral contrast medium for demonstrating the distal small bowel during breath-hold T2-weighted MRI.