Performance of two neutral oral contrast agents in CT enterography

Abstract

Mannitol achieves studies of better quality and is now the preferred oral contrast for CTE studies at Auckland City Hospital.

CT enterography: Mannitol versus VoLumen

“…Lauenstein et al 6 raised the possibility that Mannitol could have diarrhoea as a potential side effect given its activity as an osmotic agent, however, it is reassuring that no significant difference in side effects was identified between the Mannitol or Metamucil. 15 Our study confirms that there are no differences in side effects experienced by patients having either Mannitol or VoLumen with low rates of nausea, vomiting and diarrhoea. Despite the small numbers of feedback due to the 19 patients were lost to follow-up, there was a representative sample from each group.…”

“…Following this, Auckland City Hospital has adopted Mannitol use for CTE. 15 Our current results demonstrate no significant difference between luminal distension or proportion of loops distended between the two agents. However, significantly better wall visibility was demonstrated with Mannitol in the right lower quadrant, left upper quadrant and left lower quadrant.…”

“…Because there were promising results using Mannitol in MRE, a formal comparison of these agents in CTE demonstrated that Mannitol achieves better wall visibility in the right lower quadrant and studies of a better quality compared to Metamucil. Following this, Auckland City Hospital has adopted Mannitol use for CTE …”

“…Therefore, this was not thought to be a viable concern for comparing image quality and our conclusions with regard to wall visibility are valid. Inhomogeneous content within the fasted small bowel, which is particularly evident with psyllium fibre preparation, 15 can limit the ability to assess for intraluminal lesions. 15 This was not an issue with either Mannitol or VoLumen and only a single case of Mannitol demonstrated inhomogeneous contrast.…”

“…Images were assessed in soft tissue windows on a workstation via a picture archiving and communication system (AGFA Impax). The following format is similar to some previous studies which enables ease of comparison . The abdomen was divided into four quadrants using a line through the umbilicus to divide the abdomen into left and right and a line through the level of the iliac crests divided it into upper and lower divisions.…”