title: Evaluation of bowel distension and mural visualisation using neutral oral contrast agents for multidetector-row computed tomography.
abstract: BACKGROUND
  We compared the effectiveness of different types of non-commercial neutral oral contrast agents for bowel distension and mural visualisation in computed tomographic (CT) enterography.
  
  
  METHODS
  90 consecutive patients from a group of 108 were randomly assigned to receive water (n = 30), 3.8% milk (n = 30) or 0.1% gastrografin (n = 30) as oral contrast agent. The results were independently reviewed by two radiologists who were blinded to the contrast agents used. The degree of bowel distension was qualitatively scored on a four-point scale. The discrimination of bowel loops, mural visualisation and visualisation of mucosal folds were evaluated on a 'yes' or 'no' basis. Side effects of the various agents were also recorded.
  
  
  RESULTS
  3.8% milk was significantly superior to water for bowel distension (jejunum, ileum and terminal ileum), discrimination of bowel loops (jejunum and ileum), mural visualisation and visualisation of mucosal folds (ileum and terminal ileum). It was also significantly superior to 0.1% gastrografin for bowel distension, discrimination of bowel loops, mural visualisation and visualisation of mucosal folds (jejunum, ileum and terminal ileum). However, 10% of patients who received 3.8% milk reported immediate post-test diarrhoea. No side effects were documented for patients who received water and 0.1% gastrografin.
  
  
  CONCLUSIONS
  3.8% milk is an effective and superior neutral oral contrast agent for the assessment of the jejunum, ileum and terminal ileum in CT enterography. However, further studies are needed to explore other suitable oral contrast agents for CT enterography in lactose- or cow's milk-intolerant patients.
authors.affiliation: Department of Biomedical Imaging, University of Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia. beekuan76@hotmail.com
authors.forename: Bee Kuan
authors.initials: BK
authors.lastname: Lim
authors.forename: Shaik Ismail
authors.initials: SI
authors.lastname: Bux
authors.forename: Kartini
authors.initials: K
authors.lastname: Rahmat
authors.forename: Sze Yin
authors.initials: SY
authors.lastname: Lam
authors.forename: Yew Wai
authors.initials: YW
authors.lastname: Liew
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D003287:Contrast Media / Q000494:pharmacology*; D003974:Diatrizoate Meglumine / Q000494:pharmacology; D005260:Female; D006801:Humans; D007422:Intestines / Q000000981:diagnostic imaging* / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D008892:Milk; D061330:Multidetector Computed Tomography / Q000295:instrumentation* / Q000379:methods; D014867:Water
chemical_list: D003287:Contrast Media; D014867:Water; D003974:Diatrizoate Meglumine