Gd-DTPA (Magnevist® Enteral) for gastrointestinal use with 1 mmolar required concentration.

See also Positive Oral Contrast Agents.

GastroMARK® belongs to the negative oral contrast agents (same as Lumirem®, another brand name for ferumoxsil). GastroMARK® is used to distinguish the loops of the bowel from other abdominal structures and physiology. When GastroMARK® is ingested, it flows through and darkens the stomach and the small intestine in 30 to 45 minutes. By more clearly identifying the intestinal loops, GastroMARK® improves visualization of adjacent abdominal tissues such as the pancreas.

Rectal staging is necessary for the preoperative assessment of intra- and extramural tumor infiltration or the decision for adjuvant radio-chemotherapy. One indication of MRI with luminal contrast enhancement is small bowel enteroclysis after duodenal intubation for visualization of inflammatory bowel wall thickening and other complications.
"Double contrast" enhancement of the bowel lumen is the administration of plain water or water with methylcellulose along with heavily T2 weighted sequences or contrast enhanced T1 weighted sequences.
Several oral contrast agents have been used for small bowel MRI: Mannitol, metamucil, locust bean gum, and PEG. All provide sufficient bowel distension and homogeneity, but suffer from side effects such as diarrhea. The volume of PEG or mannitol administered must be not too large in order to achieve the best compromise between distension and acceptance by the patient.
MR colonography with positive bowel lumen enhancement requires higher concentrations of paramagnetic agents compared to the available dedicated enteral contrast agents, IV compounds are used to dope water enemas for this purpose.
Some investigators advocate negative bowel enhancement with Contrast Agents to suppress high signal bowel content in MRCP ( Magnetic resonance cholangiopancreaticography ). The use of a mixture of metamucil and 20 ml of gadolinium chelate provides good homogeneity and good tolerance without diarrhea.

Lumirem® belongs to the negative oral contrast agents (same as GastroMARK®, another brand name for ferumoxsil). Lumirem® is used to distinguish the loops of the bowel from other abdominal structures and physiology. When Lumirem® is ingested, it flows through and darkens the stomach and the small intestine in 30 to 45 minutes. By more clearly identifying the intestinal loops, Lumirem® improves visualization of adjacent abdominal tissues such as the pancreas.
Additionally, in Europe Lumirem® is approved for rectal administration to delineate the lower intestinal system.

Magnevist® enteral (Gadopentetate) is a Gd-DTPA solution for use as a gastrointestinal contrast agent to visualize the bowel in MRI scans.

See also Positive Oral Contrast Agents and Gadopentetate Gastrointestinal.