Categories of negative oral contrast agents:
Negative oral contrast media are usually based on superparamagnetic particles and act by inducing local field inhomogeneities, which results in shortening of both T1 and T2 relaxation times. Superparamagnetic contrast agents have predominant T2 weighted effects. Biphasic contrast media are agents that have different signal intensities on different sequences, depending on the concentration at which they are used.
Suitable materials for oral contrast agents should have little or no absorption by the stomach or intestines, complete excretion, no motion or susceptibility artifacts, affordability, and uniform marking of the gastrointestinal tract. Benefits of negative oral contrast agents are the reduction of ghosting artifacts caused by the lack of signal. Superparamagnetic iron oxides produce also in low concentrations a noticeable signal loss; but can generate susceptibility artifacts especially in gradient echo sequences. Perfluorochemicals do not dilute in the bowel because they are not miscible with water.
High cost, poor availability, and limited evaluations of side effects are possible disadvantages.
Negative oral contrast agents are used e.g., in MRCP, where the ingestion of 600-900 ml of SPIO cancels out the signal intensity of the lumen (in addition after the injection of a gadolinium-based contrast medium, the enhancement of the inflammatory tissues is clearer seen), and in MR abdominal imaging of Crohn's disease in combination with mannitol.

Blueberry or pineapple juices are useable for examinations of the pancreas (MRCP, upper abdominal imaging) as cheep contrast agents, because of the content of magnetic substances (e.g. manganese).

See also Ferristene, Ferumoxsil, Oral Magnetic Particles, Gastrointestinal Imaging.

Nitroxide radicals (or nitroxyl spin labels) are stable organic compounds with theoretical potential for use as a paramagnetic MRI contrast agent. Similar to gadolinium they have an unpaired electron, a property that provides enhancement in T1 based MRI, and a comparable pharmacokinetic. Depending on their structure and chemical bonding, different nitroxides formula may have the potential for use as cardiovascular imaging agents, to enhance the MR imaging on joints (e.g., dendrimer-linked nitroxides have a strong affinity for cartilage), to evaluate brain tumors and infarction, and as a contrast enhancement agent of body/abdominal NMR imaging. Nitroxides are rapidly enzymatically reduced in tissues to products that do not enhance the NMR signal, which can be a problem for MR imaging. In animal experiments with EPRI (electron paramagnetic resonance imaging), tissue redox studies show differences between tumors and normal tissues, which reflect their respective redox status consistent with the reduction/clearance of nitroxides.

Omniscan® is a nonionic chelate complex with low osmolality used as a paramagnetic MRI contrast agent. The efficacy of Omniscan® is similar to that of Gd-DTPA. Omniscan® is given intravenously to enhance images of intracranial and spinal lesions where there is abnormal vascularity or an abnormal blood brain barrier. The complex does not cross an intact blood brain barrier so Omniscan® only accumulates in lesions such as neoplasm's and abscesses.

WARNING: NEPHROGENIC SYSTEMIC FIBROSIS Gadolinium-based contrast agents increase the risk for nephrogenic systemic fibrosis (NSF) in patients with acute or chronic severe renal insufficiency (glomerular filtration rate less than 30 mL/min/1.73m²), or acute renal insufficiency of any severity due to the hepato-renal syndrome or in the perioperative liver transplantation period.

See also Gadodiamide, and Classifications, Characteristics, etc.

Short name: P760, chemical compound: tetraazacyclododecanetetraacetic acid (DOTA), central moity: Gd
P760 (Guerbet SA) is a low-diffusion gadolinium complex with a macrocyclic core based on a tetraazacyclododecanetetraacetic acid (DOTA) structure, which is substituted with bulky hydrophilic groups. The relaxivity of P760 at 0.47 T is very high compared to Gd-DOTA.

Types of oral contrast agents with positive signal enhancement:
Ideal oral contrast agents are immiscible with water, biologically inert, have a low viscosity and surface tension. Oral positive contrast agents may improve the separation of bowel loops, the detection of polyps in colon MRI or the assessment of inflammatory bowel in the small intestine. Several positive oral contrast agents are available and they are safe to use, for example gadolinium solution, ferric ammonium citrate, different oil emulsions and pediatric formula.
Unfavorably motion artifacts caused by respiration and peristalsis may be increased in MR imaging. In addition, the signal of the positive contrast medium may decrease caused by dilution in gastrointestinal (GI) secretions. With the use of contrast agents that are immiscible with water, no dilution and accompanying signal loss occur even when the contrast agent is in contact with the intraluminal contents of the GI tract. Another disadvantage may be residual substances in the bowel, resembling masses when enclosed by bright signal. In addition, positive contrast agents may have a similar signal as bright masses, which make their (e.g. lipoma) detection difficult.

See also Gastrointestinal Paramagnetic Contrast Agents, Combination Oral Contrast Agents, Gastrointestinal Diamagnetic Contrast Agents.