Comparison of neutral and positive enteral contrast media for MDCT enteroclysis.
OBJECTIVE
To compare neutral and positive enteral contrast media for MDCT enteroclysis (MDCTE) in various small bowel diseases.


METHODS
40 patients with suspicion of small bowel diseases were divided randomly into two equal groups. In one group, water was used as neutral enteral contrast and in other group, 2% water soluble iodinated contrast was used as positive enteral contrast. All MDCTE were done on a 16-slice multidetector row CT unit. The findings of MDCTE were compared with the standards of reference.


RESULTS
There were 12 cases of abdominal tuberculosis (30%), 5 cases of bowel masses (12%), 4 cases of Crohn's disease (10%), 3 cases of small bowel adhesions (7%), 2 cases of midgut volvulus (5%), 2 cases of segmental enteritis (5%) and 12 of all cases (30%) were normal. There was no statistically significant difference between neutral and positive enteral contrast with regards to bowel distention, contrast reflux and evaluation of duodenum. Abnormal bowel wall enhancement was appreciated only with use of neutral enteral contrast (n=12). Evaluation of ileocaecal junction was possible in all 20 patients (100%) with positive enteral contrast but in only 17 patients (85%) with neutral enteral contrast. Overall sensitivity and specificity of MDCTE with use of neutral contrast medium (100 and 88% respectively) was greater for evaluation of small bowel diseases, when compared to MDCTE using positive enteral contrast medium (92.8 and 83.3% respectively).


CONCLUSIONS
Water is a good enteral contrast medium for MDCT enteroclysis examination and allows better evaluation of abnormal bowel wall enhancement. Ileocaecal junction evaluation is better with positive enteral contrast medium.
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012, India.
Senthil Kumar
SK
Aiyappan
Naveen
N
Kalra
Manavjit Singh
MS
Sandhu
Rakesh
R
Kochhar
Jai Dev
JD
Wig
Niranjan
N
Khandelwal
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D016009:Chi-Square Distribution; D003287:Contrast Media; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000000981:diagnostic imaging*; D007421:Intestine, Small; D007472:Iohexol; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014867:Water
D003287:Contrast Media; D014867:Water; D007472:Iohexol