Effect of the dose and route of administration of butylscopolamine on the reduction of the artifacts associated with intestinal peristalsis in abdominal magnetic resonance

To compare the effect of the route of administration (intravenous and oral) and the dose (40 mg and 80 mg) of butylscopolamine, determining its efficacy in reducing the noise associated with gastrointestinal movement in magnetic resonance (MR) images and the incidence and severity of associated adverse reactions. The present prospective, controlled, double-blind study included 80 patients who underwent abdominal MR. All the patients were given oral, high-density barium sulfate and were divided randomly into 4 groups of 20 patients each: a control group and 3 groups treated with 40 mg or 80 mg of oral butylscopolamine or 40 mg of intravenous butylscopolamine. Both the barium and the oral solutions were administered 25 to 30 minutes before the examination. the MR images were obtained with a STIR sequence (1487/100/44), and qualitative analysis of the noise was carried out using regions of interest situated in the background. The gastrointestinal noise was defined both by the mean and the standard deviation of the signal intensity of the air front of an behind the patient. The standard deviation of the air beside the patient was determined to confirm the absence of variations in noise inherent to MR. The adverse reactions to MR after 2 hours (immediate) and one day (late) were recorded. There were no significant differences among the groups with respect to sex, age or time interval between administration of the oral solution and the start of the sequence. The noise inherent to MR was not significantly different from one group to another (Student-Newman-Keuls test, p=0.71). Both the mean and the standard deviation of the intensity of the air situated in anteroposterior phase-encoding direction were significantly lower in the butylscopolamine groups than in the control group (Student-Newman-Keuls test, p=0.008). The most marked reduction was observed after the oral dose of 80 mg, followed by intravenous injection of 40 mg and the oral dose of 40 mg. Adverse reaction were observed in only 4 patients, 2 in the i. v. butylscopolamine group (mild abdominal pain and dry mouth), 1 in the oral 40 mg group (bad taste in mouth) and 1 in the control group (nausea). The combination of a drug to inhibit peristalsis and a negative oral contrast agent significantly reduces the intensity of artifacts in abdominal MR imaging. In view of its efficacy, route of administration and adverse reaction profile, the oral administration of 80 mg of butylscopolamine can be considered a safe and effective option. (Author) 12 refs