Spasmolysis at CT colonography: butyl scopolamine versus glucagon.
OBJECTIVE
To retrospectively determine if the use of butyl scopolamine or glucagon in the supine patient improves colonic distention and reduces the number of collapsed intestinal segments at computed tomographic (CT) colonography.


METHODS
This study had institutional review board approval; subject informed consent was not required. CT colonography was performed without the administration of an intravenous spasmolytic in 80 asymptomatic subjects (group 1; 45 women, 35 men; age range, 48-77 years; mean, 61.9 years). These subjects were matched with two groups of 80 subjects who were similar in age but were premedicated with glucagon (group 2; 41 women, 39 men; age range, 43-76 years; mean, 63.1 years) or butyl scopolamine (group 3; 43 women, 37 men; age range, 34-77 years; mean, 63.4 years). All 240 subjects were examined in the supine position with multisection CT and a section thickness of 1 mm after intravenous contrast agent administration and rectal carbon dioxide insufflation. The colon was divided into seven segments, and the colon length, total volume, radial distensibility, and number of non-distended segments were calculated for each subject and compared among the three groups. Statistical analysis was performed with analysis of variance and chi2 testing.


RESULTS
Mean bowel length was not significantly different among the groups. Mean colon volumes and radial distensibilities, respectively, were 1.84 L and 3.69 cm in group 1, 2.14 L and 3.98 cm in group 2, and 2.35 L and 4.23 cm in group 3; differences in colon volume and radial distensibility were significant only between group 1 and group 3 (P < .001). At CT colonography, 29 segments in 20 group 1 subjects were collapsed, 23 segments in 12 group 2 subjects were collapsed, and 11 segments in six group 3 subjects were collapsed (P = .016).


CONCLUSIONS
Premedication with butyl scopolamine or, less effectively, glucagon improves colonic distention in the supine subject.
Rogalla
Patrik
P
Department of Radiology, Charité Campus Mitte, Universitätsmedizin Berlin, Schumannstr 20/21, 10098 Berlin, Germany. rogalla@charite.de
Lembcke
Alexander
A
Rückert
Jens C
JC
Hein
Eike
E
Bollow
Matthias
M
Rogalla
Noga E
NE
Hamm
Bernd
B
D000368:Aged; D000704:Analysis of Variance; D002086:Butylscopolammonium Bromide; D016009:Chi-Square Distribution; D023881:Colonography, Computed Tomographic; D005260:Female; D005765:Gastrointestinal Agents; D005934:Glucagon; D006801:Humans; D008297:Male; D008875:Middle Aged; D010276:Parasympatholytics; D012189:Retrospective Studies; D016683:Supine Position
D005765:Gastrointestinal Agents; D010276:Parasympatholytics; D002086:Butylscopolammonium Bromide; D005934:Glucagon