Small bowel MRI using water as a contrast medium

Magnetic resonance imaging (MRI) of the small bowel has been limited by lack of an adequate luminal contrast medium and problems with image artefacts. In this study we investigate the feasibility of imaging the luminal small bowel using rapid heavily T2w techniques, similar to those used for MR cholangiopancreatography, combined with oral water loading. Eight volunteers were examined after drinking 1-2 l of water using serial, multisection, half-Fourier single shot rapid acquisition with relaxation enhancement (RARE) acquisitions. The examinations were continued until the terminal ileum was reached or the water reabsorbed. The results were subjectively assessed for visibility of the small bowel. In all subjects the duodenum, jejunum and ileum were well demonstrated with valvulae conniventes clearly visible. The water column reached the terminal ileum and the caecum in six of the eight subjects but in the remaining two water remained in the small bowel and was ultimately reabsorbed. These preliminary results suggest that with further refinement such an approach may be practical for clinical magnetic resonance imaging of the small bowel.