Evaluation of neutral oral contrast agents for assessment of the small bowel at abdominal staging CT


Autoři: Till F. Kaireit aff001;  Carolin Huisinga aff001;  Matti Peperhove aff001;  Frank Wacker aff001;  Kristina I. Ringe aff001
Působiště autorů: Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany aff001
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225160

Souhrn

Background

Although neutral oral contrast agents are widely in use, a consensus regarding a standardized protocol in abdominal staging CT does not exist.

Purpose

To test the null hypothesis that there is no quantitative or qualitative difference between water and mannitol for evaluation of the small bowel at abdominal staging CT.

Material and methods

180 patients prospectively underwent abdominal staging CT with oral administration of either 1 liter mannitol solution (n = 88) or water (n = 92). Intestinal distension was measured in 6 different segments of the small intestine. In addition, two radiologists separately evaluated diagnostic image quality with regards to luminal distension (three-point scale) in each segment and the possibility to rule out a possible underlying pathology. Quantitative and qualitative results were compared (Mann-Whitney test).

Results

Quantitatively, intestinal distension was comparable in all segments (p>0.05), except for the horizontal duodenum (p = 0.019). The mean luminal diameter over all intestinal segments was 19.0 mm (18.1–19.9 mm) for the water group and 18.4 mm (17.5–19.2 mm) for the mannitol group, respectively. Qualitatively, ratings were comparable for the first three segments, while distal segments were rated better using mannitol. Side effects were only observed using mannitol (n = 26; 29.5%).

Conclusions

Orally administered water and mannitol solution for evaluation of the small bowel at abdominal staging CT in clinical routine resulted in comparable results for the quantitative, but not for the qualitative analysis. Looking more differentiated at the overall performance, water has advantages in terms of patient comfort, side effects and costs, and can therefore be regarded as noninferior to mannitol in this specific patient group.

Klíčová slova:

Computed axial tomography – Diagnostic medicine – duodenum – Gastrointestinal tract – Ileum – Jejunum – Mannitol – Oral administration


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2019 Číslo 11