Evaluation of the Performance of Neutral Oral Contrast Materials: A Computered Tomography Enterography Study

Aslıhan Onay; Barış Bakır

doi:10.4274/atfm.galenos.2020.43660

Evaluation of the Performance of Neutral Oral Contrast Materials: A Computered Tomography Enterography Study

Abstract

Objectives: We aimed to compare the performances of two neutral oral contrast agents, polyethylene glycol (PEG) and lactulose solution. Materials and Methods: The computed tomography enterography (CT-E) data of 54 consecutive patients that either used lactulose solution or PEG were retrospectively analyzed and measurements were made by the mutual agreement of 2 radiologists. The radiological records of patients were also evaluated by including technician’s notes regarding patient compliance with instructions and a questionnaire to be filled out by the patients about oral contrast agent related discomfort. The intestinal distension and patient’s tolerance were compared between the lactulose solution and PEG groups. The relationship between the lactulose solution and PEG groups was analyzed using the Student’s t-test for continuous variables with normal distribution, and the Mann-Whitney U test for continuous variables without normal distribution. The relationship between the lactulose group and the PEG group in terms of patient tolerance was evaluated using the chi-square test. Results: The intestinal distention provided by the lactulose group in the duodenal segments was superior to that of the PEG group (p<0.001). We observed no significant difference in the jejunum and ileum between two oral contrast agents (p=0.747 and p=0.662). Lactulose was better tolerated when compared to PEG (likelihood ratio=7.38, p=0.025). Conclusion: Lactulose is the preferred oral contrast agent for CT-E studies due to its achievement in duodenal distension and its better tolerance.

Keywords

Ethical Statement

Etik Kurul Onayı: İstanbul Üniversitesi İstanbul Tıp Fakültesi Etik Kurulu’ndan onay alınmıştır (Karar no: 25, tarih: 16/10/2020). Hasta Onayı: Retrospektif çalışma. Hakem Değerlendirmesi: Editörler kurulunun dışından olan kişiler tarafından değerlendirilmiştir. Yazarlık Katkıları Cerrahi ve Medikal Uygulama: B.B., Konsept: B.B., A.O.Ç., Dizayn: B.B., A.O.Ç., Veri Toplama veya İşleme: B.B., A.O.Ç, Analiz veya Yorumlama: B.B., A.O.Ç., Literatür Arama: A.O.Ç, Yazan: A.O.Ç. Çıkar Çatışması: Yazarlar tarafından çıkar çatışması bildirilmemiştir. Finansal Destek: Yazarlar tarafından finansal destek almadıkları bildirilmiştir.

References

1. Markova I, Kluchova K, Zboril R, et al. Small bowel imaging - still a radiologic approach? Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2010;154:123-132.
2. Ilangovan R, Burling D, George A, et al. CT enterography: review of technique and practical tips. Br J Radiol. 2012;85:876-886.
3. Paparo F, Garlaschi A, Biscaldi E, et al. Computed tomography of the bowel: a prospective comparison study between four techniques. Eur J Radiol. 2013;82:1-10.
4. Rondonotti E, Villa F, Mulder CJ, et al. Small bowel capsule endoscopy in 2007: indications, risks and limitations. World J Gastroenterol. 2007;13:6140-6149.
5. Huprich JE, Fletcher JG. CT enterography: principles, technique and utility in Crohn’s disease. Eur J Radiol. 2009;69:393-397.
6. D’Ippolito G, Braga FA, Resende MC, et al. Computed tomography enterography: a comparison of different neutral oral contrast agents. Radiol Bras. 2012;45:139-143.
7. Lim BK, Bux SI, Rahmat K, et al. Evaluation of bowel distension and mural visualisation using neutral oral contrast agents for multidetector-row computed tomography. Singapore Med J. 2012;53:732-736.
8. Wang YR, Yu XL, Peng ZY. Evaluation of different small bowel contrast agents by multi - detector row CT. Int J Clin Exp Med. 2015;8:16175-16182.

9. Leduc F, De A, Rebello R, et al. A Comparative Study of Four Oral Contrast Agents for Small Bowel Distension with Computed Tomography Enterography. Can Assoc Radiol J. 2015;66:140-144.
10. Wong J, Roger M, Moore H. Performance of two neutral oral contrast agents in CT enterography. J Med Imaging Radiat Oncol. 2015;59:34-38.
11. Megibow AJ, Babb JS, Hecht EM, et al. Evaluation of bowel distention and bowel wall appearance by using neutral oral contrast agent for multidetector row CT. Radiology. 2006;238:87-95.
12. Ilangovan R, Burling D, George A, et al. CT enterography: review of technique and practical tips. Br J Radiol. 2012;85:876-886.
13. Cronin CG, Lohan DG, DeLappe E, et al. Duodenal abnormalities at MR small-bowel follow-through. AJR Am J Roentgenol. 2008;191:1082-1092.
14. Amitai MM, Raviv-Zilka L, Hertz M, et al. Main Imaging Features of Crohn’s Disease: Agreement between MR-Enterography and CT-Enterography. Isr Med Assoc J. 2015;17:293-297.
15. Evrimler Ş, Ocakoğlu G, Algin O. The efficacy of new oral contrast mixture for computed tomography enterography. Pol J Radiol. 2019;84:403-412.
16. Voskuijl W, de Lorijn F, Verwijs W, et al. PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial. Gut. 2004;53:1590-1594.
17. Belsey JD, Geraint M, Dixon TA. Systematic review and meta analysis: polyethylene glycol in adults with non-organic constipation. Int J Clin Pract. 2010;64:944-955.

Details

Primary Language

English

Subjects

Radiology and Organ Imaging

Journal Section

Research Article

Authors

Aslıhan Onay ^*
0000-0003-4213-9126
Türkiye

Barış Bakır This is me
0000-0002-6587-9787
Türkiye

Publication Date

April 30, 2021

Submission Date

April 25, 2020

Acceptance Date

June 3, 2020

Published in Issue

Year 2021 Volume: 74 Number: 1

DOI

https://doi.org/10.4274/atfm.galenos.2020.43660

IZ

https://izlik.org/JA94JE97JW

Cite

RIS / Bibtex

APA

Onay, A., & Bakır, B. (2021). Evaluation of the Performance of Neutral Oral Contrast Materials: A Computered Tomography Enterography Study. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 74(1), 90-96. https://doi.org/10.4274/atfm.galenos.2020.43660

AMA

1.Onay A, Bakır B. Evaluation of the Performance of Neutral Oral Contrast Materials: A Computered Tomography Enterography Study. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2021;74(1):90-96. doi:10.4274/atfm.galenos.2020.43660

Chicago

Onay, Aslıhan, and Barış Bakır. 2021. “Evaluation of the Performance of Neutral Oral Contrast Materials: A Computered Tomography Enterography Study”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 74 (1): 90-96. https://doi.org/10.4274/atfm.galenos.2020.43660.

EndNote

Onay A, Bakır B (April 1, 2021) Evaluation of the Performance of Neutral Oral Contrast Materials: A Computered Tomography Enterography Study. Ankara Üniversitesi Tıp Fakültesi Mecmuası 74 1 90–96.

IEEE

[1]A. Onay and B. Bakır, “Evaluation of the Performance of Neutral Oral Contrast Materials: A Computered Tomography Enterography Study”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 74, no. 1, pp. 90–96, Apr. 2021, doi: 10.4274/atfm.galenos.2020.43660.

ISNAD

Onay, Aslıhan - Bakır, Barış. “Evaluation of the Performance of Neutral Oral Contrast Materials: A Computered Tomography Enterography Study”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 74/1 (April 1, 2021): 90-96. https://doi.org/10.4274/atfm.galenos.2020.43660.

JAMA

1.Onay A, Bakır B. Evaluation of the Performance of Neutral Oral Contrast Materials: A Computered Tomography Enterography Study. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2021;74:90–96.

MLA

Onay, Aslıhan, and Barış Bakır. “Evaluation of the Performance of Neutral Oral Contrast Materials: A Computered Tomography Enterography Study”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 74, no. 1, Apr. 2021, pp. 90-96, doi:10.4274/atfm.galenos.2020.43660.

Vancouver

1.Aslıhan Onay, Barış Bakır. Evaluation of the Performance of Neutral Oral Contrast Materials: A Computered Tomography Enterography Study. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2021 Apr. 1;74(1):90-6. doi:10.4274/atfm.galenos.2020.43660