Ralph Berther MD, Abstract Co-Author: Nothing to Disclose

Michael A. Patak MD, Presenter: Nothing to Disclose

Sukru Mehmet Erturk MD, Abstract Co-Author: Nothing to Disclose

Boris Eckhardt MD, Abstract Co-Author: Nothing to Disclose

Christoph L. Zollikofer MD, Abstract Co-Author: Nothing to Disclose

To compare a neutral oral contrast agent with water equivalent intraluminal attenuation (3% Manitol solution, ie 30g Mannitol solved in 1000cc of water) to a positive contrast (Telebrix Gastro, Megluminioxitalamat, Guerbet, France) in abdominal MDCT.

100 patients were prepared with positive oral contrast agent (Telebrix Gastro) according to routine clinical protocol and compared to 100 patients with neutral oral contrast agent (3% Mannitol). The scanning protocol was the same for all patients. The image analysis was first a qualitative assessment (1-5 subjective scale) of the overall image quality, bowel distention, homogeneity of the lumen, differentiation of the bowel wall, the presence of artifacts done by three experienced readers, blinded to the contrast. Secondly quantitative measurements of diameter and attenuation (in HU) were performed on the level of stomach, duodenum, jejunum, and terminal ileum.

The distension of the entire small bowel, the homogeneity of the applied contrast, the detection of the internal and external border of the bowel wall and the rate of artifacts were interpreted as being significantly better (p< 0.001) in the Mannitol-images compared to the images with Iodine as contrast. In all locations but the stomach, the diameter measurement showed a significant difference with the Mannitol group being higher.

The quantitative and qualitative results of the study lead to the conclusion that the use of Mannitol as an oral contrast results in a better image quality, lower artifact rate and better distension with a clear delineation of the small bowel wall compared to a positive intraluminal oral contrast.

A 3% Manitol-solution is a valid neutral oral contrast for abdominal MDCT with a higher image quality, better distension and clear delieation of the bowel wall compared to iodinated oral contrast.

Berther, R, Patak, M, Erturk, S, Eckhardt, B, Zollikofer, C, Mannitol as a Neutral Oral Contrast in Abdominal MDCT: A Comparison of Low Attenuation Contrast versus Positive Intraluminal Contrast.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4440749.html