Purpose: Improvement of pelvic MRI using peroral administration of an aqueous mannitol solution.
Methods: We retrospectively evaluated magnetic resonance examinations of 72 patients with suspected or proven pelvic abnormalities: In 36 patients, no bowel marking was carried out. In further 36 patients, we performed a contrast enhancement of the bowel by oral application of 1000 ml of an aqueous mannitol solution.
Results: 8/36 (22%) patients suffered from diarrhoea, nausea or meteorism as a result of mannitol application. In group 2, an excellent bowel marking of the small intestine could be obtained in 36/36 (100%) patients. Contrast enhancement of the bowel significantly improved delineation between intestinal structures and pelvic organs or pathologic lesions, respectively. In summary, bowel marking was desirable in 25/36 (69%) of group 1 and helpful in 26/36 (72%) of group 2.
Conclusion: Aqueous mannitol solution is a safe bowel contrast agent and improves the diagnostic value of pelvic MRI, but in some cases delineation between marked bowel and cystic pelvic lesions may be uncertain.