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.

Paramagnetic substances, for example Gd-DTPA solutions, are used as MRI oral contrast agents in gastrointestinal imaging to depict the lumen of the digestive organs. Different Gd-DTPA solutions or zeolites containing gadolinium can be used e.g., for diagnosis of delayed gastric emptying, diagnosis of Crohn's disease etc.
Low concentrations of gastrointestinal paramagnetic contrast agents cause a reduction in T1 relaxation time; consequently, these agents act on T1 weighted images by increasing the signal intensity of the bowel lumen. High concentrations cause T2 shortening by decreasing the signal, similar to superparamagnetic iron oxide. Gd-DTPA chelates are unstable at the low pH in the stomach, therefore buffering is necessary for oral use.

See also Gadopentetate Gastrointestinal, Gadolinium Zeolite, Negative Oral Contrast Agents, Gastrointestinal Superparamagnetic Contrast Agents, and Ferric ammonium citrate.

(GEMS) This pulse sequence uses a changeable flip angle instead of a 90° pulse and a gradient instead of a RF pulse to rephase the FID.
T2*, T1 weighted and proton density images can be acquired. The flip angle in combination with the TR determines the T1 weighting and the TE controls the amount of dephasing. To minimize T2* the echo time should be short.

See also Gradient Echo Sequence.

The characteristics of a hepatobiliary contrast agent are specific liver uptake and excretion via the biliary system. The paramagnetic substance (e.g. manganese, gadolinium) is taken up by normal hepatocytes. Diseased liver tissue did not include hepatocytes or their function is disturbed. Therefore, the signal of healthy liver tissue increases on T1 weighted sequences, but not in the liver lesions.
Another type of liver imaging contrast agent is superparamagnetic iron oxide. These particles accumulate in the reticuloendothelial system (RES) of the liver, and darken the healthy liver tissue in T2 weighted images. RES cells (including Kupffer cells) are existing in healthy liver tissue, in altered tissue with reduced RES activity or without RES cells the contrast agent concentration is also low or not existing, which improves the liver to lesion contrast.
Benefits of hepatobiliary contrast agents:
Differences of a hepatobiliary contrast agent compared with a targeted contrast agent for Kupffer cells:
See also Superparamagnetic Contrast Agents, Hepatobiliary Chelates, Liver Imaging, Endoremâ„¢, Primovistâ„¢, and Classifications, Characteristics, etc.

See also the related poll result: 'The development of contrast agents in MRI is'

The term in phase refers to an image in which the signals from two spectral components (such as fat and water) add constructively in a voxel. T1 weighted in phase images are acquired by a gradient echo-based technique with a short TR, TE and a high flip angle greater than 60 degrees. To some degree, in phase sequences are more sensitive to detection of focal hepatic lesions than out of phase for evaluating reduced lesion-to-liver contrast, but the choice for a T1 gradient echo sequence is still based on field strength, advanced imaging techniques (breath hold imaging), and physician preference.