Medical Imaging and Radiotherapy Journal (MIRTJ) 39 (Suppl. 1) 35 Medical Imaging and Radiotherapy Journal (MIRTJ) 39 (Suppl. 1) MRCP S PROSTO DOSTOPNIMI NEGATIVNIMI KONTRASTNIMI SREDSTVI MRCP WITH THE USE OF OVER-THE-COUNTER NEGATIVE CONTRAST AGENTS Teja Aškerc 1, Nejc Mekiš 2, Andrej Breznik 1 1 Splošna Bolnišnica Celje, Radiološki oddelek, Oblakova ulica 5, 3000 Celje, 1000 Slovenija / General Hospital Celje, Department of Radiology, Oblakova ulica 5, 3000 Celje, 1000 Slovenia 2 Univerza v Ljubljani, Zdravstvena fakulteta, Oddelek za radiološko tehnologijo, Zdravstvena pot 5, 1000 Ljubljana, Slovenija / University of Ljubljana, Faculty of health sciences, Medical Imaging and Radiotherapy Department, Zdravstvena pot 5, 1000 Ljubljana, Slovenia Korespondenca / Corresponding author: askerc.teja@gmail.com Prejeto/Recived: 13. 10. 2019 Sprejeto/Accepted: 3. 3. 2022 IZVLEČEK Uvod: Magnetno resonančna holangiopankreatografi ja (MRCP) je neinvazivna slikovna diagnostika, namenjena prikazovanju biliarnega trakta in pankreatičnih vodov. Alternativa dragim in slabo dostopnim suspenzijam superparamagnetnih delcev so sokovi, ki vsebujejo višje koncentracije mangana, kot so borovničev sok, ananasov sok, sok acai jagod in črni čaj. Namen: Zanimalo nas je, ali obstaja razlika v kakovosti slike med nativno sliko in po zaužitju različnih negativnih kontrastnih sredstev, ter katero od področij PBT je najbolje vidno po uporabi negativnih kontrastnih sredstev. Metode: V raziskavo smo vključili 20 zdravih prostovoljcev in prostovoljk. Slike smo primerjali z nativno sliko, ki je bila narejena isti dan kot slika z izbranim negativnim kontrastnim sredstvom. Preiskovanci so posamično zaužili tri različna negativna kontrastna sredstva (ananasov sok, borovničev sok in črni čaj). Med uporabo posamičnih kontrastnih sredstev je moralo preteči vsaj 24 ur. Nativni fazi je sledila druga faza z uporabo negativnega kontrastnega sredstva 10 minut po zaužitju le-tega. Slike sta ocenila dva izkušena radiologa, ki sta na slikah ocenjevala kakovost slik po zaužitju negativnega kontrastnega sredstva. Rezultati in razprava: Ugotovili smo, da se pri uporabi vseh vrst negativnih kontrastnih sredstev nakazuje podoben trend vidljivosti anatomskih struktur. Najboljše rezultate oz. kakovost slik smo dosegli z uporabo ananasovega soka. Ugotovili smo statistično značilne razlike v kakovosti izničenja signala iz želodca, dvanajstnika, trebušne slinavke, žolčnih vodov in papile Vateri. Pri uporabi črnega čaja nismo ugotovili statistično značilnih razlik. Zaključek: Na slikah, ki so nastale po zaužitju ananasovega ali borovničevega soka, je v primerjavi z nativno sliko bolj jasno vidno, da je učinkovito in signal iz želodca, dvanajstnika ter proksimalnega dela črevesja zasičen. Črni čaj je dobil najslabše ocene, ker se nobena od opazovanih anatomskih struktur na sliki po zaužitem kontrastnem sredstvu ni videla bolje. Ključne besede: MRCP, negativno kontrastno sredstvo, ananasov sok, borovničev sok, črni čaj, vizualizacija ABSTRACT Introduction: Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive MR examination technique that provides us with information about the anatomy and pathology of the bile ducts. Alternatives to expensive negative contrast agents are over-the-counter beverages that contain higher concentrations of manganese, such as blueberry juice, pineapple juice, and black tea. Purpose: To investigate whether the use of negative over- the-counter contrast agents improves the quality of MRCP examination, which of them provide better visualization of the pancreato-biliary tract (PBT), and in which areas of the PTB the greatest diff erences are seen. Methods: Measurements were performed on 20 healthy volunteers. We started with »native« imaging of the PBT area, and at least 24-hour intervals, the volunteers ingested three diff erent negative contrast agents such as pineapple juice, blueberry juice, and black tea. The examinations were repeated 10 minutes after ingestion of the contrast agents. Images were evaluated by two experienced radiologists who assessed the improvement in visualization after contrast ingestion. Results: A comparison between pineapple juice and blueberry juice showed that there were no statistically signifi cant diff erences between them, but pineapple juice had an insignifi cantly higher score compared with all anatomic structures. We found a statistically signifi cant diff erence in signal suppression in the stomach, duodenum, pancreatic duct, common bile duct, and papillae Vateri after ingestion of pineapple juice and blueberry juice. Statistical analysis showed no signifi cant diff erences after the consumption of black tea. Discussion and Conclusion: We found that pineapple juice and blueberry juice were both equally suitable for performing MRCP examination, as they best suppressed the signal from the gastrointestinal tract and allowed better visualization of the PBT, whereas black tea proved to be an ineff ective negative contrast agent. Keywords: MRCP, negative contrast media, pineapple juice, blueberry juice, black tea, visualization 36 Medical Imaging and Radiotherapy Journal (MIRTJ) 39 (Suppl. 1) Medical Imaging and Radiotherapy Journal (MIRTJ) 39 (Suppl. 1) LITERATURA / REFERENCES Arrivé L, Coudray C, Azizi L et al. (2007). Pineapple juice as a negative oral contrast agent in magnetic resonance cholangiopancreatography. J Radiol 88(11):1689-94. Bittman ME, Callahan MJ (2014). The eff ective use of acai juice, blueberry juice and pineapple juice as negative contrast agents for magnetic resonance cholangiopancreatography in children. Pediatr Radiol 44(7): 883-7. doi: 10.1007/ s00247-014-2884-5. 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