Efficacy of oral date syrup in enhancing Magnetic Resonance Cholangiopancreatography: a preliminary study

Objective: To assess the efficacy of oral date syrup in suppressing upper gastrointestinal (GI) tract signals and enhancing visualization of pancreatico-biliary structures on magnetic resonance cholangiopancreatography (MRCP). Methods: This prospective study was conducted at Department of Radiology, Khyber Teaching Hospital, Peshawar, Pakistan, from January to June 2019. Forty healthy volunteers, with no history of diabetes or GI disorders, underwent MRCP before and 30 minutes after oral administration of 100 ml undiluted date syrup. Imaging was performed on a 1.5T Philips MRI scanner using breath-hold MRCP sequences. Two blinded radiologists independently assessed the suppression of upper GI fluid signals and visibility of the common bile duct (CBD) and main pancreatic duct (MPD) using a standardized 4-point scale. Discrepancies were resolved by consensus. Statistical analysis was performed using SPSS v.22, with a p-value <0.05 considered significant. Results: All participants completed the study without adverse effects. Radiologist-A observed significant signal suppression in the stomach and duodenum and improved visualization of both CBD (p=0.003) and MPD (p=0.001). Radiologist-B noted improved visibility of the CBD (p=0.002), with borderline significance for MPD (p=0.065). Contrast-to-noise ratio analysis showed significant improvement in CBD vs. duodenum and MPD vs. stomach (p<0.001). Conclusion: Oral date syrup significantly suppresses upper gastrointestinal signals and improves visualization of panscreatico-biliary structures on MRCP. It appears to be a well-tolerated, cost-effective alternative to conventional negative oral contrast agents. However, larger multicenter studies are needed to confirm these findings and support the routine use of date syrup as a natural contrast agent in clinical practice.