Alessia Tognolini MD, Presenter: Research grant, Toshiba Corporation, Tustin, CA

Iryna Rastarhuyeva, Abstract Co-Author: Nothing to Disclose

Milliam Lika Kataoka MD, Abstract Co-Author: Nothing to Disclose

Giulia A. Zamboni MD, Abstract Co-Author: Nothing to Disclose

Vassilios D. Raptopoulos MD, Abstract Co-Author: Research grant, Toshiba Corporation, Tustin, CA Research grant, E-Z-EM, Inc, Lake Success, NY

To compare the imaging properties of low in density barium sulphate oral contrast agents in bowel distension, mucosal detail, and mural visualisation and enhancement.

Sixty patients were enrolled in this prospective IRB approved and HIPAA compliant study. Written consent was obtained and 4 concentrations of Barium sulphate with Sorbitol (0.4%, 0.5%, 0.63% and 0.76%; E-Z-EM, Canada Inc.), were compared to neutral density 0.1% Volumen and conventional high density 2.1%-Readi-cat 2. Patients and controls (10 per group, randomly) were asked to drink 4 cups (900 ml) over 1 hour and scanned with/without IV contrast on 64 MDCT scanners (Toshiba and General Electric). Luminal attenuations of stomach, duodenum, jejunum and ileum were measured; bowel distention, wall visualisation, and mucosa/fold detail were graded on a 5 point scale (0=none to 4=excellent).

Average intraluminal attenuations were 23 HU, 60 HU, 78 HU, 91 HU 125 HU and 238 HU for the 0.1%,0.4%,0.5%, 0.63%, 0.76% and 2.1 concentrations,respectively. On unhenanced scans there were no significant differences in distension or wall visualisation among the 6 concentrations: medians ranging between 3-4 and 2-3, respectively. On post-IV contrast scans, mean bowel wall attenuation ranged from 80 to120 HU. Wall visualisation and enhancement were inversely proportional to the concentration, medians ranging between 3-4 for 0.1%, 0.4% and 0.5% to 1.5-3 for 0.63% 2-3.25, 0.76% and 3-4 for 2.1. The latter required wide window, loosing enhancement information but was superior for depiction of mucosal surface. It was was also the best gastro-intestinal marker. It was felt that an in-between 0.76% and 2.1% concentration would be valuable.

The 0.1% Volumen was valuable for normal wall visualization including mucosal and wall enhancement. Readi-cat 2 was superior as GI tract marker and for depiction of structural mucosal detail. However, it was inferior to Volumen for assessment of normal wall and mucosal enhancement. The in-between concentrations tested did not appear to combine the imaging properties of the two extreme formulations.

To improve the quality of low density in barium oral contrast medium in abdominal MDCT

Tognolini, A, Rastarhuyeva, I, Kataoka, M, Zamboni, G, Raptopoulos, V, Comparison of Various Low Hounsfield-Unit-Value Barium Sulphate Oral Contrast Agents for Abdominal CT: From VOLUMEN to READI-CAT.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5014305.html