Categories of negative oral
contrast agents:
Negative oral
contrast media are usually based on superparamagnetic particles and act by inducing local field inhomogeneities, which results in shortening of both T1 and
T2 relaxation times.
Superparamagnetic contrast agents have predominant
T2 weighted effects.
Biphasic
contrast media are agents that have different signal intensities on different
sequences, depending on the concentration at which they are used.
Suitable materials for
oral contrast agents should have little or no absorption by the stomach or intestines, complete excretion, no motion or
susceptibility artifacts, affordability, and uniform marking of the gastrointestinal tract.
Benefits of negative
oral contrast agents are the reduction of ghosting artifacts caused by the lack of signal. Superparamagnetic iron oxides produce also in low concentrations a noticeable signal loss; but can generate
susceptibility artifacts especially in
gradient echo sequences.
Perfluorochemicals do not dilute in the bowel because they are not miscible with water.
High cost, poor availability, and limited evaluations of side effects are possible disadvantages.
Negative
oral contrast agents are used e.g., in
MRCP, where the ingestion of 600-900 ml of
SPIO cancels out the
signal intensity of the lumen (in addition after the injection of a gadolinium-based
contrast medium, the enhancement of the inflammatory tissues is clearer seen), and in MR
abdominal imaging of Crohn's disease in combination with mannitol.