Dose optimization of mannitol solution for small bowel distension in MRI

Purpose To optimize the dose of a hydro solution containing 2.5% mannitol and 0.2% locust bean gum (LBG) for small bowel MRI in terms of bowel distension and patient acceptance. Materials and Methods A total of 10 healthy volunteers ingested a hydro solution containing 2.5% mannitol and 0.2% LBG. Four different volumes (1500, 1200, 1000, and 800 ml) were assessed on four different examination days. Small bowel distension was quantified on coronal two‐dimensional TrueFISP images by measuring the diameter of eight bowel loops throughout the jejunum and the ileum. In addition, volunteer acceptance was evaluated for every single examination by using a questionnaire. Results Optimal distension was obtained with either, 1000, 1200, or 1500 ml, with no statistically significant differences in distension between these groups. Administration of 800 ml led to significantly less distension of the small bowel. Significantly less side effects were noted using either 800 or 1000 ml compared to using larger volumes. Conclusion We recommend a dose of 1000 ml mannitol/LBG solution as an oral contrast agent for optimal bowel distension and minimal side effects. J. Magn. Reson. Imaging 2004;20:648–653. © 2004 Wiley‐Liss, Inc.