title: Quantitative and qualitative bowel analysis using mannitol, water and iodine-based endoluminal contrast agent on 64-row detector CT.
abstract: OBJECTIVE
  To assess the performance of mannitol as a luminal contrast as compared to water and positive contrast in evaluation of bowel on multidetector computed tomography (MDCT).
  
  
  METHODS
  Three hundred patients were randomly selected for this study and were divided equally into three groups. Each subject received 1500 ml of oral contrast. Group 1 received 3% mannitol in water, group 2 received diluted iodinated positive contrast, and group 3 received plain water without additives. Qualitative and quantitative analysis for distension, fold visibility, and overall image quality were analyzed by actual diameter measurement and point scale system at different bowel levels. One-way analysis of variance (ANOVA) followed by Tukey's HSD Post-hoc test and Pearson's Chi-square (exact test) test were applied.
  
  
  RESULTS
  Group 1 showed better results for small bowel distension, intraluminal homogeneity, and visibility of mucosal folds on quantitative and qualitative analysis with statistically significant P value (P<0.001). The ileo-caecal junction distension and mural feature visibility was better with mannitol (P < 0.001). No significant difference in distension of stomach and duodenum was found between the three groups.
  
  
  CONCLUSIONS
  Mannitol as endoluminal contrast increases the diagnostic accuracy of the investigative studies in comparison to water and iodine-based contrast by producing significantly better bowel distension and visibility of mural features with improved image quality without additional adverse effects.
authors.affiliation: Department of Radiodiagnosis and Imaging, Kasturba Medical College, Manipal University, Manipal, Udupi, Karnataka, India.
authors.forename: K
authors.initials: K
authors.lastname: Prakashini
authors.affiliation: Department of Radiodiagnosis and Imaging, Kasturba Medical College, Manipal University, Manipal, Udupi, Karnataka, India.
authors.forename: Chandan
authors.initials: C
authors.lastname: Kakkar
authors.affiliation: Department of Radiodiagnosis and Imaging, Kasturba Medical College, Manipal University, Manipal, Udupi, Karnataka, India.
authors.forename: Charudutt
authors.initials: C
authors.lastname: Sambhaji
authors.affiliation: Department of Radiodiagnosis and Imaging, Kasturba Medical College, Manipal University, Manipal, Udupi, Karnataka, India.
authors.forename: Chandrakant M
authors.initials: CM
authors.lastname: Shetty
authors.affiliation: Department of Radiodiagnosis and Imaging, Kasturba Medical College, Manipal University, Manipal, Udupi, Karnataka, India.
authors.forename: Vedula Rajanikanth
authors.initials: VR
authors.lastname: Rao
keywords: Bowel distension; iodinated positive contrast; mannitol; mural details; water