Evaluation of bowel by computed tomography enterography: comparing the water, mannitol and iodinated oral contrast
DOI:
https://doi.org/10.18203/2320-6012.ijrms20241886Keywords:
Endoscopy, Enterography, Iodinated oral contrast, MannitolAbstract
Background: Despite the small intestine's size and significance, disorders of it are comparatively uncommon and can pose difficulties for diagnosis and treatment. Even with the advent of cutting-edge imaging methods like double balloon endoscopy and capsule endoscopy, diagnostic tests are still unable to accurately evaluate the bowel. Recent innovations, including capsule endoscopy and MRI have emerged as an alternative small bowel imaging techniques that can be performed without ionizing radiations. In this study we have compared Water, mannitol and iodinated oral contrast for assessing intraluminal distension, mucosal fold visualization and mural enhancement.
Methods: A total of 150 patients fulfilling the selection criteria were studied. All patients of age group 25 to 70 years were included in the study. Patients with ileostomy, nasogastric tube in-situ and nil by mouth., with suspected intestinal obstruction, patient presenting with acute abdomen and fever were excluded.
Results: It was observed that mannitol, homogeneity and mannitol group showed better bowel distension than iodinated contrast and plain water group (p<0.001), iodinated contrast and plain water group. (p<0.001). Mannitol group showed better wall visibility than iodinated contrast and plain water group. (p<0.001). Mannitol is better endo-luminal contrast agent than, iodinated contrast in water and plain water to assess the overall image quality.
Conclusions: Computed tomography (CT) enterography using mannitol is excellent technique in better visualization of small bowel loops and thus helped to provide better diagnosis for intestinal abnormalities.
Metrics
References
Tavakkoli A, Ashley SW, Zinner MJ. Schwartz’s Principles of surgery. 11th ed. Mc Graw Hill; 2019:1219.
Elamparidhi P, Sivaranjanie S, Kumar RR, Sibhithran R, Kumar AA. Comparison of water, mannitol and positive oral contrast for evaluation of bowel by computed tomography. Int J Anat Radiol Surg. 2017;6(4):RO13-7.
Jens BrØndum Frokjӕr, AsbjØrn Mohr Drewes, and Hans Gregersen. Imaging of gastrointestinal tract-noval technologies. W J Gastroenterol. 2009;15(2):160-8.
Andrzejewska M, Grzymisławski M. Role of intestinal ultrasound in diagnostics of bowel diseases. Prz Gastroenterol. 2018;13(1):1-5.
Macari M, Megibow AJ, Balthazar EJ. A pattern approach to the abnormal small bowel: observations at MDCT and CT enterography. Am J Roentgenol. 2007;188(5):1344-55.
Lopez PP, Khorasani-Zadeh A. Anatomy, Abdomen and Pelvis, Duodenum. Stat Pearls: Stat Pearls Publishing; 2019.
Chaudhry SR, Peterson DC. Anatomy, Abdomen and Pelvis, Stomach. Stat Pearls: Stat Pearls Publishing; 2019.
Skandalakis JE, Skandalakis PN, Skandalakis LJ. Surgical anatomy and technique. Chirurg. 2000;71(8):954-71.
Hong SS, Kim AY, Kwon SB, Kim PN, Lee MG, Ha HK. Three-dimensional CT enterography using oral gastrografin in patients with small bowel obstruction: comparison with axial CT images or fluoroscopic findings. Abdom Imaging 2010;35(5):556-62.
Ilangovan R, Burling D, George A, Gupta A, Marshall M, Taylor SA. CT enterography: review of technique and practical tips. Br J Radiol. 2012;85(1015):876.
Zhang LH, Zhang SZ, Hu HJ, Gao M, Zhang M, Cao Q, et al. Multi-detector CT enterography with iso-osmotic mannitol as oral contrast for detecting small bowel disease. World J Gastroenterol. 2005;11(15):2324-9.
Collins JT, Badireddy M. Anatomy, Abdomen and Pelvis, Small Intestine. Stat Pearls: Stat Pearls Publishing; 2019.
Hammer MR, Podberesky DJ, Dillman JR. Multidetector computed tomographic and magnetic resonance enterography in children. Radiol Clin North Am. 2013;51(4):615-36.
Paulo GA, Martins FP, Macedo EP, Gonçalves ME, Ferrari AP. Safety of Mannitol Use in Bowel Preparation: a prospective assessment of intestinal methane (CH4) levels during colonoscopy after mannitol and sodium phosphate (NaP) bowel cleansing. Arq Gastroenterol. 2016;53(3):196-202.
Ilangovan R, Burling D, George A, Gupta A, Marshall M, Taylor SA. CT enterography: review of technique and practical tips. Br J Radiol. 2012;85(1015):876.
Tochetto S, Yaghmai V. CT enterography: concept, technique, and interpretation. Radiol Clin North Am. 2009;47(1):117-32.