title: Comparison of neutral oral contrast versus positive oral contrast medium in abdominal multidetector CT.
abstract: To determine whether neutral contrast agents with water-equivalent intraluminal attenuation can improve delineation of the bowel wall and increase overall image quality for a non-selected patient population, a neutral oral contrast agent (3% mannitol) was administered to 100 patients referred for abdominal multidetector row computed tomography (MDCT). Their results were compared with those of 100 patients given a positive oral contrast agent. Qualitative and quantitative measurements were done on different levels of the gastrointestinal tract by three experienced readers. Patients given the neutral oral contrast agent showed significant better qualitative results for bowel distension (P < 0.001), homogeneity of the luminal content (P < 0.001), delineation of the bowel-wall to the lumen (P < 0.001) and to the mesentery (P < 0.001) and artifacts (P < 0.001), leading to a significant better overall image quality (P < 0.001) than patients receiving positive oral contrast medium. The quantitative measurements revealed significant better distension (P < 0.001) and wall to lumen delineation (P < 0.001) for the patients receiving neutral oral contrast medium. The present results show that the neutral oral contrast agent (mannitol) produced better distension, better homogeneity and better delineation of the bowel wall leading to a higher overall image quality than the positive oral contrast medium in a non-selected patient population.
authors.affiliation: Institute of Radiology, Kantonsspital, Winterthur, Switzerland.
authors.forename: Ralph
authors.initials: R
authors.lastname: Berther
authors.forename: Michael A
authors.initials: MA
authors.lastname: Patak
authors.forename: Boris
authors.initials: B
authors.lastname: Eckhardt
authors.forename: Sukru M
authors.initials: SM
authors.lastname: Erturk
authors.forename: Christoph L
authors.initials: CL
authors.lastname: Zollikofer
mesh_terms: D000284:Administration, Oral; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007482:Iothalamate Meglumine / Q000008:administration & dosage; D008297:Male; D008353:Mannitol / Q000008:administration & dosage; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods*; D011860:Radiography, Abdominal / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D008353:Mannitol; D007482:Iothalamate Meglumine