The Efficacy of Pineapple Juice as a Negative Oral Contrast Agent in Magnetic Resonance Cholangiopancreatography (MRCP)

Abstract

Strong signals from the gastrointestinal tract (GIT) often degrade the quality of MRCP images due to overlapping static fluids from the GIT and pancreaticobiliary system, obscuring the common bile duct (CBD) and pancreatic duct. This study aimed to investigate the efficacy of pineapple juice as a negative oral contrast agent in magnetic resonance cholangiopancreatography (MRCP) to improve visualization of the CBD and pancreatic duct in T2-weighted images. An analytical and observational study was conducted on 17 patients from April 2024 to June 2024. MRCP was performed before and 5 minutes after the ingestion of pineapple juice. Three independent radiologists evaluated the images using a 4-point Likert scale. Signal intensity data for the CBD and pancreatic duct were recorded by measuring the mean and standard deviation using a region of interest (ROI) circle of 20mm² for CBD and 10mm² for the pancreatic duct. A statistically significant improvement was observed in the visibility and detectability of the CBD and pancreatic duct following pineapple juice ingestion (p < 0.001). Pre-ingestion scores for visibility and detectability ranged from 1.33 to 3.33, while post-ingestion scores improved to 2.67 to 4.00. Significant differences in signal intensity for the CBD (p < 0.001) and pancreatic duct (p < 0.001) were also noted. Pineapple juice is an effective negative oral contrast agent for enhancing the visualization of the CBD and pancreatic duct in T2-weighted MRCP images.