Protons in -CH2- groups, e.g., contained in fatty emulsions, mineral or vegetable oil or sucrose polyester, have a fast relaxation and short T1 time. These agents with short T1-relaxation, if used in gastrointestinal imaging, produce bright signal intensities in the intestine on T1 weighted sequences. Palatable oil emulsions can produce appropriate contrast opacification of the stomach as well as the small bowel, but caused by absorption in the distal small bowel these materials are not suitable for use in MRI colonoscopy.

See also Positive Oral Contrast Agents and Gastrointestinal Paramagnetic Contrast Agents.

(Gadolite® oral Suspension) An oral paramagnetic MRI contrast agent to enhance delineation of the bowel. Zeolites are hydrated aluminosilicates with large holes that can provide a temporary home for guest molecules like gadolinium. Zeolites modified with Gd (III) are effective positive MRI contrast agents for gastrointestinal application.

Biphasic oral contrast agents may produce either high or low signal intensities depending on the pulse sequence used, for example low signal intensity on T1 weighted MR images and high signal intensity on T2 weighted images. The combination of different oral contrast agents can generate a macroscopic cancellation of negative and positive magnetic susceptibility, thereby eliminating susceptibility artifacts.
Possible combinations are e.g., ferric ammonium citrate and corn oil, or ferrous sulfate emulsified with baby formula. Paramagnetic agents combined with oil emulsion may be used in MRI as positive abdominal contrast agents. The combination of diamagnetic barium sulfate and superparamagnetic iron oxide (SPIO) in one suspension may be a useful negative contrast agent.

See also Gastrointestinal Paramagnetic Contrast Agents, Gastrointestinal Superparamagnetic Contrast Agents, Gastrointestinal Diamagnetic Contrast Agents, Gastrointestinal Imaging.

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.