Sebastian Winklhofer1,2, Wei-Ching Lin1,3,4, Zhen Jane Wang1, Spencer C Behr1, Antonio C Westphalen1, Benjamin M Yeh1. 1. 1 Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave, Box 0628, M-372, San Francisco, CA 94143-0628. 2. 2 Department of Neuroradiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 3. 3 Department of Radiology, China Medical University Hospital, Taichung, Taiwan, Republic of China. 4. 4 Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan, Republic of China.
Abstract
OBJECTIVE: The objective of our study was to compare the quality of bowel opacification from three different positive oral contrast agents-barium sulfate, diatrizoate, and iohexol-at abdominopelvic CT. MATERIALS AND METHODS: Abdominopelvic CT examinations with three different oral contrast agents (each contrast agent: n = 300 patients) of 900 patients were retrospectively evaluated by two independent readers. For four segments of the gastrointestinal tract (i.e., the stomach, jejunum, ileum, and colon), readers recorded qualitative data (grade of nonuniform lumen opacification, types of inhomogeneous opacifications, presence of artifacts, and distribution of contrast agent) and quantitative data (CT attenuation of lumen [in Hounsfield units]). The results were compared among the three contrast agents using the Mann-Whitney U test and repeated-measures ANOVA with a post hoc Bonferroni correction. RESULTS: Fewer artifacts were detected with iohexol (4.3%) as the oral contrast agent than with diatrizoate (13.0%) and barium sulfate (14.3%) (each, p < 0.05). Barium showed a greater frequency of bowel lumen heterogeneity (388/831 segments, 47%) than iohexol (155/679, 23%) and diatrizoate (185/763, 24% segments) (p < 0.001). Barium showed higher CT attenuation than iohexol and diatrizoate in the stomach but lower CT attenuation in the ileum (each, p < 0.05). CONCLUSION: The frequency of inhomogeneous bowel opacification was lower for iohexol than for diatrizoate or barium sulfate. Barium showed the highest frequency of bowel lumen heterogeneity. The iodinated agents showed greater increases in mean CT attenuation from the proximal bowel segments to the distal bowel segments than barium sulfate.
OBJECTIVE: The objective of our study was to compare the quality of bowel opacification from three different positive oral contrast agents-barium sulfate, diatrizoate, and iohexol-at abdominopelvic CT. MATERIALS AND METHODS: Abdominopelvic CT examinations with three different oral contrast agents (each contrast agent: n = 300 patients) of 900 patients were retrospectively evaluated by two independent readers. For four segments of the gastrointestinal tract (i.e., the stomach, jejunum, ileum, and colon), readers recorded qualitative data (grade of nonuniform lumen opacification, types of inhomogeneous opacifications, presence of artifacts, and distribution of contrast agent) and quantitative data (CT attenuation of lumen [in Hounsfield units]). The results were compared among the three contrast agents using the Mann-Whitney U test and repeated-measures ANOVA with a post hoc Bonferroni correction. RESULTS: Fewer artifacts were detected with iohexol (4.3%) as the oral contrast agent than with diatrizoate (13.0%) and barium sulfate (14.3%) (each, p < 0.05). Barium showed a greater frequency of bowel lumen heterogeneity (388/831 segments, 47%) than iohexol (155/679, 23%) and diatrizoate (185/763, 24% segments) (p < 0.001). Barium showed higher CT attenuation than iohexol and diatrizoate in the stomach but lower CT attenuation in the ileum (each, p < 0.05). CONCLUSION: The frequency of inhomogeneous bowel opacification was lower for iohexol than for diatrizoate or barium sulfate. Barium showed the highest frequency of bowel lumen heterogeneity. The iodinated agents showed greater increases in mean CT attenuation from the proximal bowel segments to the distal bowel segments than barium sulfate.
Authors: Pratap C Naha; Jessica C Hsu; Johoon Kim; Shrey Shah; Mathilde Bouché; Salim Si-Mohamed; Derick N Rosario-Berrios; Philippe Douek; Maryam Hajfathalian; Parisa Yasini; Sanjay Singh; Mark A Rosen; Matthew A Morgan; David P Cormode Journal: ACS Nano Date: 2020-07-28 Impact factor: 15.881