Depiction of normal gastrointestinal anatomy with MDCT: comparison of low- and high-attenuation oral contrast media.
OBJECTIVE
To compare low- and high-attenuation oral contrast media for depiction of normal gastrointestinal anatomy with multidetector-row computed tomography (MDCT).


METHODS
A prospective, randomized study of 90 consecutive patients without known or suspected gastrointestinal disease was conducted after the approval of our Institutional Review Board. All patients underwent IV contrast-enhanced abdominal and pelvic CT scans after oral administration of 900 ml of either low- or high-attenuation barium sulphate suspension. Using a five-point scale, two radiologists independently graded distention and wall visualization of stomach, duodenum, jejunum, and ileum. The degree of distention and wall visualization was compared using Mann-Whitney U-test.


RESULTS
Duodenal, jejunal and ileal distention (p<0.05, <0.001, <0.001, respectively) and wall visualization (p<0.05, <0.01, <0.05, respectively) scores with low-attenuation contrast medium were significantly higher than those with high-attenuation barium sulphate preparation, for reader 1. Duodenal and jejunal wall visualization scores with low-attenuation contrast medium (p<0.05, <0.01, respectively) were significantly higher than those with high-attenuation contrast medium, for reader 2. Interobserver agreement was fair to good for both distention (kappa-range: 0.41-0.74) and wall visualization (kappa-range: 0.48-0.71).


CONCLUSIONS
MDCT with low-attenuation contrast medium provides distention and wall visualization of the GI tract that is equal or better than high-attenuation contrast medium.
Erturk
Sukru Mehmet
SM
Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. mehmeterturk@superonline.com
Mortelé
Koenraad J
KJ
Oliva
Maria-Raquel
MR
Ichikawa
Tomoaki
T
Silverman
Stuart G
SG
Cantisani
Vito
V
Pagliara
Elisa
E
Ros
Pablo R
PR
D000328:Adult; D000368:Aged; D001466:Barium Sulfate / Q000008:administration & dosage; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D041981:Gastrointestinal Tract / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D006801:Humans; D007472:Iohexol / Q000008:administration & dosage / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011860:Radiography, Abdominal; D018709:Statistics, Nonparametric
D003287:Contrast Media; D001466:Barium Sulfate; D007472:Iohexol; C038192:iopromide