Depiction of normal gastrointestinal anatomy with MDCT: Comparison of low- and high-attenuation oral contrast media

Abstract

Purpose To compare low- and high-attenuation oral contrast media for depiction of normal gastrointestinal anatomy with multidetector-row computed tomography (MDCT). Materials and methods A prospective, randomized study of 90 consecutive patients without known or suspected gastrointestinal disease was conducted after the approval of our Institutional Review Board. All patients underwent IV contrast-enhanced abdominal and pelvic CT scans after oral administration of 900 ml of either low- or high-attenuation barium sulphate suspension. Using a five-point scale, two radiologists independently graded distention and wall visualization of stomach, duodenum, jejunum, and ileum. The degree of distention and wall visualization was compared using Mann–Whitney U-test. Results Duodenal, jejunal and ileal distention ( p < 0.05, <0.001, <0.001, respectively) and wall visualization ( p < 0.05, <0.01, <0.05, respectively) scores with low-attenuation contrast medium were significantly higher than those with high-attenuation barium sulphate preparation, for reader 1. Duodenal and jejunal wall visualization scores with low-attenuation contrast medium ( p < 0.05, <0.01, respectively) were significantly higher than those with high-attenuation contrast medium, for reader 2. Interobserver agreement was fair to good for both distention ( κ-range: 0.41–0.74) and wall visualization ( κ-range: 0.48–0.71). Conclusion MDCT with low-attenuation contrast medium provides distention and wall visualization of the GI tract that is equal or better than high-attenuation contrast medium.