Comparison of two small bowel distending agents for enterography in pediatric small bowel imaging.

Autor: Kolbe AB; Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA. Kolbe.Amy@mayo.edu., Haas LA; Department of Pediatrics, Weill Cornell Medical College-New York Presbyterian Hospital, 525 East 68th Street, Box 139, New York, NY, USA., Bartlett DJ; Mayo Clinic School of Medicine, 200 1st St SW, Rochester, MN, 55905, USA., Iyer VR; Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA., Thomas KB; Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA., Tung J; Division of Pediatric Gastroenterology, Oklahoma University Children's Physicians, 1200 Children's Ave, Oklahoma, OK, 73104, USA., Fidler JL; Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA., Fletcher JG; Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.
Jazyk: angličtina
Zdroj: Abdominal radiology (New York) [Abdom Radiol (NY)] 2019 Oct; Vol. 44 (10), pp. 3252-3262.
DOI: 10.1007/s00261-019-02102-3
Abstrakt: Objective: To evaluate the ability of pediatric patients with known or suspected inflammatory bowel disease to ingest a new oral distending agent at CT or MR enterography (CTE/MRE), and to determine the impact on small bowel (SB) distension and diagnostic confidence.
Materials and Methods: The study design is that of retrospective review of pediatric patients who underwent CTE or MRE from January 2014 to June 2016. Patients ingested low-concentration barium suspension or flavored beverage containing sorbitol and mannitol. The need for nasogastric tube (NGT) administration, amount ingested, emesis, distal extent of contrast, SB distension, terminal ileum (TI) transverse dimension, and diagnostic confidence in TI disease were assessed. Three radiologists each blindly reviewed a subset of the studies.
Results: Of the total 591 scans in 504 patients, 316 scans used low-concentration barium suspension and 275 scans flavored beverage. Nearly all consumed the entire amount (97% vs. 96%). Low-concentration barium suspension exams required NGT more often (7% [23/316] vs. 1% [3/275]; p < 0.0003), and tended to have more emesis (3% [9/316] vs. 1% [3/275]; p = 0.13). Diagnostic confidence score was nearly identical (p = 0.94). Qualitative and quantitative analyses showed no difference in SB distension, except for distension of mid-ileum (flavored beverage > low-concentration barium suspension; p = 0.02). Flavored beverage exams demonstrated a slight increase in distal extent of luminal distension (p = 0.02).
Conclusions: A new flavored beverage distends small bowel as well as low-concentration barium suspension, with decreased requirement for NGT insertion and improved distal extent of luminal distension, and without any decrease in diagnostic confidence in the presence or the absence of TI disease.
Databáze: MEDLINE
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