Zarine Ketul Shah MD, Abstract Co-Author: Nothing to Disclose

Nisha Sainani, Presenter: Nothing to Disclose

Raul Nirmal Uppot MD, Abstract Co-Author: Nothing to Disclose

Michael Austin Blake MBBCh, Abstract Co-Author: Nothing to Disclose

Kathleen Ouellette-Piazzo, Abstract Co-Author: Nothing to Disclose

Peter Florin Hahn MD, PhD, Abstract Co-Author: Nothing to Disclose

Dushyant Vasudeo Sahani MD, Abstract Co-Author: Nothing to Disclose

Assess efficacy of small bowel distension and bowel marking using 3 bottles (1350ml) low Hounsfield value oral contrast (VoLumen- E-Z-EM Inc.) and compare this with 2 bottles of VoLumen (900ml) and a 16 fl oz. glass of water for MDCT scans of abdomen and pelvis. Assess patient compliance for the two protocols.

80 consecutive patients scheduled for routine CECT of the abdomen-pelvis were studied. Patients were randomized and administered either 1350 ml of VoLumen (2 bottles at 20 min. intervals, ½ bottle at 50min and last ½ on table) or 900ml of VoLumen (2 bottles at 20 min. intervals and 16 fl oz. water on table). Portal venous phase images (DC=0.625mm, speed=18.75mm, thickness=5mm) in the axial plane were obtained. Reformatted coronal images were obtained at 2.5mm slice thickness at the CT console. Acceptablity of the protocols was assessed via patient questioning. Two blinded readers used a pre-designed template to assess distension of the stomach and small bowel on a 5-point scale and abnormalities were recorded if detected. Average scores with the two protocols were compared using the Wilcoxon rank sum test.

The two protocols did not differ significantly in the mean scores for distension of the small bowel (4.0 vs 4.2 for VoLumen alone and VoLumen and water). The distension of the stomach was equal in both protocols. Acceptance for 2 bottles of VoLumen and water was greater among patients as compared to 3 bottles of VoLumen. Inter-observer agreement of the 2 readers was excellent (k 0.81). With the use of coronal images there was increased readers confidence in tracing the small bowel.

Administration of VoLumen and water combined is as good as VoLumen alone and has better patient compliance. Bowel distension and visualization of bowel markings does not significantly differ between the two groups. Timing of administration of oral contrast is important and should be followed.

Use of low density oral contrast improves bowel distension and visualization of bowel marking. Replacing the last bottle of VoLumen with water gives equivalent results and improves patient compliance.

Shah, Z, Sainani, N, Uppot, R, Blake, M, Ouellette-Piazzo, K, Hahn, P, Sahani, D, Gastric and Small Bowel Marking with a Low Density Oral Contrast: Comparative Performance of Low Density Barium in Combination with Water with Equal Volume Low Density Barium Alone.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4441137.html