Comparison Of Different Concentrations Of Neutral Contrast Agent In Multislice CT Enterography

Background:Multislice computedtomography enterography(MSCTE)is a fast and panoramic way to image of the small intestine,and it can be used for image post-processing.Currently,it is one of the most commonly used methods in imaging diagnosis of small intestinal diseases.Imaging diagnosis of small intestinal diseases is based on fully expand of bowel cavity and clearly displaying of intestine walls.At present,the commonly oral neutral contrast agents include mannitol(MNT)、polyethylene glycol(PEG)and lactulose in MSCTE.But there were no comparative study of these three solutions in MSCTE on their performances.Objective:To explore the best neutral contrast agent and its optimum concentration for small intestine displaying in MSCTE,then to provide reference for clinical application.Methods: Choosing 200 cases,who were standardized,by complete random method,in the First Affiliated Hospital of Henan University of Science and Technology for MSCTE,from October 2017 to July 2018.MNT group was divided into four subgroups,PEG group was divided into three subgroups,lactulose group was divided into three subgroups.a total of 10 subgroups,20 cases in each subgroup.By oralling 1600 ml MNT、PEG or lactulose to measure the intestinal diameters,the CT value between intestinal wall and intestinal cavity,and estimate the imagings of ileocecal.Results: 1.The general information of each group(gender、age、height、weight、body mass index)was consistent,and there was no significant difference;2.Given those factors(small intestine dilatation、the CT value of intestinal wall enhancement and the concentration of contrast medium),the optimum concentration of MNT was 2.0%,which was significantly different from other MNT concentration groups(P<0.05);the optimum of PEG was 5.0%,which was significantly different from other PEG groups(P<0.05);the optimum concentration of lactulose was 1.6%,which was significantly different from other lactulose groups(P<0.05);3.The best groups of ileocecal imaging were 5.0% MNT group,5.0% PEG group and 10.0% PEG group,1.6% lactulose group and 3.2% lactulose group,which had significant difference compared with other groups(P<0.05).4.Among the 2.0% MNT group、5.0% PEG group and 1.6% lactulose group(those three groups were better than others in imaging of intestinal),the best dilation of intestinal cavity was 2.0% MNT group,the best CT value between intestinal wall enhancement and the medium were 2.0% MNT group and 1.6% lactulose group,which were significantly different from 5.0% PEG group(P<0.05);the best imaging of ileocecal was 5.0% MNT group,which was significantly different from other groups(P<0.05).Conclusions: According to the patient’s conditions and pathology,we should oral different neutral contrast agents in MSCTE.When they have some contraindications of lactulose,we’d better choose 2.0% MNT;when they have some contraindications of MNT,we’d better choose 1.6% lactulose;when they have contraindication of lactulose and MNT,we’d better choose 5.0% PEG;When we suspecte the lesions in duodenal,low concentration contrast medium is recommended;When we suspecte the lesions in ileocecal,high concentration contrast medium is recommended.