Depiction of peritoneal disease in the middle abdomen requires distention and separation of bowel loops. This can be easily accomplished by having the patient drink two to three bottles of ReadiCat 2, starting 30 minutes prior to the MR examination.6 From experience we have found that drinking the barium more rapidly and then scanning immediately provides better distention of small bowel. The dilute barium serves as a positive oral contrast agent on the T2-weighted images and as a negative oral contrast agent on the T1-weighted SGE images.
We have begun to use rectal water for distention of the colon. We administer 500 to 1000 cc of rectal water via an enema tip just prior to the gadolinium injection. Distending the rectosigmoid colon is particularly important in patients with ovarian cancer who may have primary or recurrent pelvic tumor involving the rectum, sigmoid colon, or bladder.
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