L. Marti-bonmati et al., Dose effect of dicyclomine on the reduction of peristaltic artifacts on MRI of the abdomen, ABDOM IMAG, 24(4), 1999, pp. 336-339
Background: It has been demonstrated that oral administration of dicyclomin
e significantly reduces the noise associated with the movement of the gastr
ointestinal tract in abdominal magnetic resonance (MR) images. Our objectiv
e was to determine the efficacy and security of two different doses of oral
dicyclomine for the reduction of the gastrointestinal noise in abdominal M
R imaging.
Methods: Forty-eight patients with MR imaging of the upper abdomen were enr
olled in a prospective, controlled, randomized, and double-blind study. All
patients ingested barium of high density (196 g in 130 mL of tap water, 25
0 w/v) approximately 25 min before the MR examination. Patients were random
ly distributed into three groups of 16 patients each: (a) no-drug control g
roup, (b) 20 mg of dicyclomine chlorhydrate, and (c) 80 mg of dicyclomine c
hlorhydrate. Quantitative image analysis was performed with region-of-inter
est measurements of the signal intensity in background air posterior and la
teral to the patient and in the liver. Adverse effects were counted at 2 h
and 1 day after the MR examination.
Results: The liver and incoherent noise signal intensities were not statist
ically different among groups. The control group presented a gastrointestin
al noise (mean and SD of the air signal intensity) that was statistically s
uperior to that of the groups With dicyclomine (p = 0.004 and p = 0.001, re
spectively), although significant differences were not observed between the
two dicyclomine groups. Although the differences were not significant, adv
erse effects were mon frequently associated with the higher doses of dicycl
omine. All the adverse effects (most frequently, constipation, diarrhea, an
d abdominal pain) were considered minor and did not require treatment.
Conclusion: Oral dicyclomine is effective and safe for the reduction of per
istaltic artifacts on abdominal MR imaging. The dose of 20 mg presents an e
fficacy similar to that of 80 mg, with a probably lower incidence of advers
e reactions.