Quantitative and Qualitative Bowel Analysis Using Mannitol, Water and Iodine-based Endoluminal Contrast Agent on 64-row Detector CT

Overview

Journal Indian J Radiol Imaging

Publisher Thieme

Specialty Radiology

Date 2014 Mar 8

PMID 24604944

Citations 4

Authors

K Prakashini

Chandan Kakkar

Charudutt Sambhaji

Chandrakant M Shetty

Vedula Rajanikanth Rao

Affiliations

Soon will be listed here.

Abstract

Objective: To assess the performance of mannitol as a luminal contrast as compared to water and positive contrast in evaluation of bowel on multidetector computed tomography (MDCT).

Materials And Methods: Three hundred patients were randomly selected for this study and were divided equally into three groups. Each subject received 1500 ml of oral contrast. Group 1 received 3% mannitol in water, group 2 received diluted iodinated positive contrast, and group 3 received plain water without additives. Qualitative and quantitative analysis for distension, fold visibility, and overall image quality were analyzed by actual diameter measurement and point scale system at different bowel levels. One-way analysis of variance (ANOVA) followed by Tukey's HSD Post-hoc test and Pearson's Chi-square (exact test) test were applied.

Results: Group 1 showed better results for small bowel distension, intraluminal homogeneity, and visibility of mucosal folds on quantitative and qualitative analysis with statistically significant P value (P<0.001). The ileo-caecal junction distension and mural feature visibility was better with mannitol (P < 0.001). No significant difference in distension of stomach and duodenum was found between the three groups.

Conclusion: Mannitol as endoluminal contrast increases the diagnostic accuracy of the investigative studies in comparison to water and iodine-based contrast by producing significantly better bowel distension and visibility of mural features with improved image quality without additional adverse effects.

Citing Articles

Exploring the Use of Computed Tomography Enterography in the Evaluation of Small Bowel Disease: A Prospective Study.

S B D, H C S, G S G, Yeli R, C N S, Kumar M P Cureus. 2024; 16(5):e60915.

PMID: 38910779 PMC: 11193681. DOI: 10.7759/cureus.60915.

Comparison of Mannitol, Water, and Iodine-Based Oral Contrast in the Evaluation of the Bowel by Multi-Detector Computed Tomography.

Thati S, Nagegowda R, Sakalecha A, Savagave S, Patil D Cureus. 2022; 14(4):e24316.

PMID: 35607530 PMC: 9122339. DOI: 10.7759/cureus.24316.

Evaluation of different small bowel contrast agents by multi - detector row CT.

Wang Y, Yu X, Peng Z Int J Clin Exp Med. 2015; 8(9):16175-82.

PMID: 26629131 PMC: 4659020.

Mannitol an adjuvant in local anaesthetic solution: recent concept & changing trends (review).

Kumar A, Khanna R, Srivastava R, Ali I, Wadhwani P J Clin Diagn Res. 2015; 8(11):GE01-4.

PMID: 25584240 PMC: 4290259. DOI: 10.7860/JCDR/2014/9629.5187.

References

Megibow A, Babb J, Hecht E, Cho J, Houston C, Boruch M . Evaluation of bowel distention and bowel wall appearance by using neutral oral contrast agent for multi-detector row CT. Radiology. 2005; 238(1):87-95. DOI: 10.1148/radiol.2381041985. View

Horton K, Fishman E . The current status of multidetector row CT and three-dimensional imaging of the small bowel. Radiol Clin North Am. 2003; 41(2):199-212. DOI: 10.1016/s0033-8389(02)00121-5. View

RAMSAY D, Markham D, Morgan B, Rodgers P, Liddicoat A . The use of dilute Calogen as a fat density oral contrast medium in upper abdominal computed tomography, compared with the use of water and positive oral contrast media. Clin Radiol. 2001; 56(8):670-3. DOI: 10.1053/crad.2001.0772. View

Friedrich J, Skinningsrud K, Welter C, Eide H, Merkle E . Oral administration of iopentol (Imagopaque 300 mg I/ml) compared with amidotrizoate (Peritrast 300 mg I/ml), both diluted to 2% (v/v), in imaging of the gastrointestinal tract in abdominal contrast enhanced CT. A clinical trial assessing patient.... Eur Radiol. 1997; 7 Suppl 4:S140-4. DOI: 10.1007/pl00006881. View

Wold P, Fletcher J, Johnson C, Sandborn W . Assessment of small bowel Crohn disease: noninvasive peroral CT enterography compared with other imaging methods and endoscopy--feasibility study. Radiology. 2003; 229(1):275-81. DOI: 10.1148/radiol.2291020877. View

Hebert J, Taylor A, Winter T, Reichelderfer M, Weichert J . Low-attenuation oral GI contrast agents in abdominal-pelvic computed tomography. Abdom Imaging. 2005; 31(1):48-53. DOI: 10.1007/s00261-005-0350-4. View

Reittner P, Goritschnig T, Petritsch W, Doerfler O, Preidler K, Hinterleitner T . Multiplanar spiral CT enterography in patients with Crohn's disease using a negative oral contrast material: initial results of a noninvasive imaging approach. Eur Radiol. 2002; 12(9):2253-7. DOI: 10.1007/s00330-002-1361-y. View

Horton K, Fishman E . Multidetector-row computed tomography and 3-dimensional computed tomography imaging of small bowel neoplasms: current concept in diagnosis. J Comput Assist Tomogr. 2004; 28(1):106-16. DOI: 10.1097/00004728-200401000-00019. View

Turetschek K, Schober E, Wunderbaldinger P, Bernhard C, Schima W, Puespoek A . Findings at helical CT-enteroclysis in symptomatic patients with crohn disease: correlation with endoscopic and surgical findings. J Comput Assist Tomogr. 2002; 26(4):488-92. DOI: 10.1097/00004728-200207000-00002. View

10.

Garrett P, Meshkov S, Perlmutter G . Oral contrast agents in CT of the abdomen. Radiology. 1984; 153(2):545-6. DOI: 10.1148/radiology.153.2.6484186. View

11.

Lauenstein T, Schneemann H, Vogt F, Herborn C, Ruhm S, Debatin J . Optimization of oral contrast agents for MR imaging of the small bowel. Radiology. 2003; 228(1):279-83. DOI: 10.1148/radiol.2281020161. View

12.

Zhang L, Zhang S, Hu H, Gao M, Zhang M, Cao Q . Multi-detector CT enterography with iso-osmotic mannitol as oral contrast for detecting small bowel disease. World J Gastroenterol. 2005; 11(15):2324-9. PMC: 4305819. DOI: 10.3748/wjg.v11.i15.2324. View

13.

Furukawa A, Saotome T, Yamasaki M, Maeda K, Nitta N, Takahashi M . Cross-sectional imaging in Crohn disease. Radiographics. 2004; 24(3):689-702. DOI: 10.1148/rg.243035120. View

14.

Borthne A, Abdelnoor M, Storaas T, Pierre-Jerome C, Klow N . Osmolarity: a decisive parameter of bowel agents in intestinal magnetic resonance imaging. Eur Radiol. 2006; 16(6):1331-6. DOI: 10.1007/s00330-005-0063-7. View

15.

Meindl T, Hagl E, Reiser M, Mueller-Lisse U . Comparison of 2 different protocols for ingestion of low-attenuating oral contrast agent for multidetector computed tomography of the abdomen. J Comput Assist Tomogr. 2007; 31(2):218-22. DOI: 10.1097/01.rct.0000237813.26301.73. View

16.

Berther R, Patak M, Eckhardt B, Erturk S, Zollikofer C . Comparison of neutral oral contrast versus positive oral contrast medium in abdominal multidetector CT. Eur Radiol. 2008; 18(9):1902-9. DOI: 10.1007/s00330-008-0958-1. View