Efficacy of oral date syrup in enhancing Magnetic Resonance Cholangiopancreatography: a preliminary study

Main Article Content

Kalsoom Nawab
Irsa Shuaib
Anwar Ul Haq
Samia Iftikhar
Hina Gul
Mehmood Akhtar
Humaira Anjum

Abstract

Objective: To assess the efficacy of oral date syrup in suppressing upper gastrointestinal (GI) tract signals and enhancing visualization of pancreatico-biliary structures on magnetic resonance cholangiopancreatography (MRCP).


Methods: This prospective study was conducted at Department of Radiology, Khyber Teaching Hospital, Peshawar, Pakistan, from January to June 2019. Forty healthy volunteers, with no history of diabetes or GI disorders, underwent MRCP before and 30 minutes after oral administration of 100 ml undiluted date syrup. Imaging was performed on a 1.5T Philips MRI scanner using breath-hold MRCP sequences. Two blinded radiologists independently assessed the suppression of upper GI fluid signals and visibility of the common bile duct (CBD) and main pancreatic duct (MPD) using a standardized 4-point scale. Discrepancies were resolved by consensus. Statistical analysis was performed using SPSS v.22, with a p-value <0.05 considered significant.


Results: All participants completed the study without adverse effects. Radiologist-A observed significant signal suppression in the stomach and duodenum and improved visualization of both CBD (p=0.003) and MPD (p=0.001). Radiologist-B noted improved visibility of the CBD (p=0.002), with borderline significance for MPD (p=0.065). Contrast-to-noise ratio analysis showed significant improvement in CBD vs. duodenum and MPD vs. stomach (p<0.001).


Conclusion: Oral date syrup significantly suppresses upper gastrointestinal signals and improves visualization of panscreatico-biliary structures on MRCP. It appears to be a well-tolerated, cost-effective alternative to conventional negative oral contrast agents. However, larger multicenter studies are needed to confirm these findings and support the routine use of date syrup as a natural contrast agent in clinical practice.

Article Details

How to Cite
Nawab, Kalsoom, et al. “Efficacy of Oral Date Syrup in Enhancing Magnetic Resonance Cholangiopancreatography: A Preliminary Study”. KHYBER MEDICAL UNIVERSITY JOURNAL, vol. 17, no. 2, June 2025, pp. 208-12, doi:10.35845/kmuj.2025.23049.
Section
Original Articles

References

1. Zhong L, Xiao SD, Stoker J, Nj Tytgat G. Magnetic resonance cholangiopancreatography. Chin J Dig Dis 2004;5(4):139-48. https://doi.org/10.1111/j.1443-9573.2004.00174.x

2. Isoda H, Kataoka M, Maetani Y, Kido A, Umeoka S, Tamai K, et al. MRCP imaging at 3.0 T vs. 1.5 T: preliminary experience in healthy volunteers. J Magn Reson Imaging 2007;25(5):1000-6. https://doi.org/10.1002/jmri.20892

3. Govindarajan A, Lakshmanan PM, Sarawagi R, Prabhakaran V. Evaluation of date syrup as an oral negative contrast agent for MRCP. AJR Am J Roentgenol 2014;203(5):1001-5. https://doi.org/10.2214/ajr.13.12299

4. Riordan RD, Khonsari M, Jeffries J, Maskell GF, Cook PG. Pineapple juice as a negative oral contrast agent in magnetic resonance cholangiopancreatography: a preliminary evaluation. Br J Radiol 2004;77(924):991-9. https://doi.org/10.1259/bjr/36674326

5. Papanikolaou N, Karantanas A, Maris T, Gourtsoyiannis N. MR cholangiopancreatography before and after oral blueberry juice administration. J Comput Assist Tomogr 2000;24(2):229-34. https://doi.org/10.1097/00004728-200003000-00008

6. Chu ZQ, Ji Q, Zhang JL. Orally administered lemon/orange juice improved MRCP imaging of pancreatic ducts. Abdom Imaging 2010;35(3):367-71. https://doi.org/10.1007/s00261-009-9514-y

7. Sanchez TA, Elias Jr J, Colnago LA, de Almeida Troncon LE, de Oliveira RB, Baffa O, et al. Clinical feasibility of Acai (Euterpe oleracea) pulp as an oral contrast agent for magnetic resonance cholangiopancreatography. J Comput Assist Tomogr 2009;33(5):666-71. https://doi.org/10.1097/rct.0b013e31819012a0

8. Pinho KEP, Pinho AC, Pisani JC, Goedert CA, Gusso AM, Gewehr PM, et al. Açai juice as contrast agent in MRCP exams: qualitative and quantitative image evaluation. Braz Arch Biol Technol. 2019; 62:1678-4324. https://doi.org/10.1590/1678-4324-2019160697

9. Ghanaati H, Rokni-Yazdi H, Jalali AH, Abahashemi F, Shakiba M, Firouznia K. Improvement of MR cholangiopancreatography (MRCP) images after black tea consumption. Eur Radiol 2011;21(12):2551-7. https://doi.org/10.1007/s00330-011-2217-0

10. Mikkelsen D, Watson J, Vallo J. The use of banana in MRCP. Acta Radiol 2005;46(2):215-6. https://doi.org/10.1080/02841850510021139

11. Bittman ME, Callahan MJ. The effective use of acai juice, blueberry juice and pineapple juice as negative contrast agents for magnetic resonance cholangiopancreatography in children. Pediatr Radiol 2014;44(7):883-7. https://doi.org/10.1007/s00247-014-2884-5

12. Delaney L, Applegate KE, Karmazyn B, Akisik MF, Jennings SG. MR cholangiopancreatography in children: feasibility, safety, and initial experience. Pediatr Radiol 2008;38(1):64-75. https://doi.org/10.1007/s00247-007-0644-5

13. Bach-Gansmo T, Dupas B, Gayet-Delacroix M, Lambrechts M. Abdominal MRI using a negative contrast agent. Br J Radiol 1993;66(785):420–5. https://doi.org/10.1259/0007-1285-66-785-420

14. Markova I, Polakova K, Tucek P, Mashlan M, Novak P, Zboril R, et al. MR entero- graphy with a new negative oral contrast solution containing maghemite nanoparticles. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2012;156(3):229-35. https://doi.org/10.5507/bp.2012.001

15. Rinck PA, Myhr G, Smevik O, Børseth A. Orale magnetische Partikel als MR-Kontrastmittel für den Gastrointestinaltrakt [Oral magnetic particles as an MR contrast medium for the gastrointestinal tract]. Rofo 1992;157(6):533-8. https://doi.org/10.1055/s-2008-1033058

16. Hiraishi K, Sagami A, Hisada Y, Yamamoto K, Saika Y, Adachi I, et al. Contrast enhancement effect of new oral agent (blueberry juice) for upper abdominal MR imaging. Nihon Igaku Hoshasen Gakkai Zasshi 1994;54(6):539-41.

17. Chen CW, Liu YS, Chen CY, Tsai HM, Chen SC, Chuang MT. Use of carbon dioxide as negative contrast agent for magnetic resonance cholangio- pancreatography. World J Radiol 2011;3(2):47-50. https://doi.org/10.4329/wjr.v3.i2.47

18. Chan JH, Tsui EY, Yuen MK, Szeto ML, Luk SH, Wong KP, et al. Gadopentetate dimeglumine as an oral negative gastrointestinal contrast agent for MRCP. Abdom Imaging 2000;25(4):405-8. https://doi.org/10.1007/s002610000018

19. Sugita R, Nomiya T. Disappearance of the common bile duct signal caused by oral negative contrast agent on MR cholangiopancreatography. J Comput Assist Tomogr 2002;26(3):448–50. https://doi.org/10.1097/00004728-200205000-00023

20. Takahara T, Saeki M, Nosaka S, Shimoyamada K, Suemitsu I, Nakajima Y, et al. The use of high concentration ferric ammonium citrate (FAC) solution as a negative bowel contrast agent: application in MR cholangiography. Nihon Igaku Hoshasen Gakkai Zasshi 1995;55(9):697-9.

Similar Articles

1 > >> 

You may also start an advanced similarity search for this article.