دورية أكاديمية
أعرض في EDS

A prospective study comparing water only with positive oral contrast in patients undergoing abdominal CT scan.

التفاصيل البيبلوغرافية
العنوان: A prospective study comparing water only with positive oral contrast in patients undergoing abdominal CT scan.
المؤلفون: de Wit PAM; Amsterdam UMC, University of Amsterdam, Department of Radiology & Nuclear Medicine, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands. p.a.dewit@amsterdamumc.nl., Tielbeek JAW; Amsterdam UMC, University of Amsterdam, Department of Radiology & Nuclear Medicine, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands., van Diepen PR; Amsterdam UMC, University of Amsterdam, Department of Radiology & Nuclear Medicine, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands., Oulad Abdennabi I; Amsterdam UMC, University of Amsterdam, Department of Radiology & Nuclear Medicine, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands., Beenen LFM; Amsterdam UMC, University of Amsterdam, Department of Radiology & Nuclear Medicine, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands., Bipat S; Amsterdam UMC, University of Amsterdam, Department of Radiology & Nuclear Medicine, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands.
المصدر: Scientific reports [Sci Rep] 2020 Apr 22; Vol. 10 (1), pp. 6813. Date of Electronic Publication: 2020 Apr 22.
نوع المنشور: Comparative Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : Nature Publishing Group, copyright 2011-
مواضيع طبية MeSH: Tomography, X-Ray Computed*, Abdomen/*diagnostic imaging , Contrast Media/*administration & dosage , Water/*administration & dosage, Administration, Oral ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Observer Variation ; Organ Specificity ; Prospective Studies ; Radiation Exposure
مستخلص: Consecutive adults scheduled to undergo abdominal CT with oral contrast were asked to choose between 1000 ml water only or positive oral contrast (50 ml Télébrix-Gastro diluted in 950 ml water). Two abdominal radiologists independently reviewed each scan for image quality of the abdomen, the diagnostic confidence per system (gastrointestinalsystem/organs/peritoneum/retroperitoneum/lymph nodes) and overall diagnostic confidence to address the clinical question (not able/partial able/fully able). Radiation exposure was extracted from dose reports. Differences between both groups were evaluated by Student's t-test, Mann-Whitney-U-test or chi-square-test. Of the 320participants, 233chose water only. All baseline characteristics, image quality of the abdomen and the diagnostic confidence of the organs were comparable between groups and both observers. Diagnostic confidence in the water only group was more commonly scored as less than good by observer1. The results were as follows: the gastrointestinal system(18/233vs1/87; p = 0.031), peritoneum (21/233vs1/87; p = 0.012), retroperitoneum (11/233vs0/87; p = 0.040) and lymph nodes (11/233vs0/87; p = 0.040). These structures were scored as comparable between both groups by observer2. The diagnostic confidence to address the clinical question could be partially addressed in 6/233 vs 0/87 patients (p = 0.259). The water only group showed a tendency towards less radiation exposure. In summary, most scan ratings were comparable between positive contrast and water only, but slightly favored positive oral contrast for one reader for some abdominal structures. Therefore, water only can replace positive oral contrast in the majority of the outpatients scheduled to undergo an abdominal CT.
References: Harieaswar, S., Rajesh, A., Griffin, Y., Tyagi, R. & Morgan, B. Routine use of positive oral contrast material is not required for oncology patients undergoing follow-up multidetector CT. Radiology. 250, 246–253 (2009). (PMID: 10.1148/radiol.2493080353)
Payor, A. et al. Efficacy of Noncontrast Computed Tomography of the Abdomen and Pelvis for Evaluating Nontraumatic Acute Abdominal Pain in the Emergency Department. J. Emerg. Med. 49, 886–892 (2015). (PMID: 10.1016/j.jemermed.2015.06.062)
Razavi, S. A., Johnson, J. O., Kassin, M. T. & Applegate, K. E. The impact of introducing a no oral contrast abdominopelvic CT examination (NOCAPE) pathway on radiology turn around times, emergency department length of stay, and patient safety. Emerg. Radiol. 21, 605–613 (2014). (PMID: 10.1007/s10140-014-1240-2)
Wolfe, J. M. et al. The impact of body mass index on concordance in the interpretation of matched noncontrast and contrast abdominal pelvic computed tomographic scans in ED patients with nontraumatic abdominal pain. Am. J. Emerg. Med. 24, 144–148 (2006). (PMID: 10.1016/j.ajem.2005.08.015)
Uyeda, J. W. et al. Evaluation of Acute Abdominal Pain in the Emergency Setting Using Computed Tomography Without Oral Contrast in Patients With Body Mass Index Greater Than 25. J. Comput. Assist. Tomogr. 39, 681–686 (2015). (PMID: 10.1097/RCT.0000000000000277)
Garcia, C. M. et al. The Impact of Enteric Contrast on Radiologist Confidence in Intravenously Enhanced MDCT of the Abdomen and Pelvis: A Randomized Controlled Trial. Advances in Computed Tomography 3, 18–23 (2014). (PMID: 10.4236/act.2014.32004)
Kammerer, S. et al. Abdominal and pelvic CT: is positive enteric contrast still necessary? Results of a retrospective observational study. Eur. Radiol. 25, 669–78 (2015). (PMID: 10.1007/s00330-014-3446-9)
Buttigieg, E. L., Grima, K. B., Cortis, K., Soler, S. G. & Zarb, F. An evaluation of the use of oral contrast media in abdominopelvic CT. Eur. Radiol. 24, 2936–2944 (2014). (PMID: 10.1007/s00330-014-3285-8)
Lee, C. H., Gu, H. Z., Vellayappan, B. A. & Tan, C. H. Water as neutral oral contrast agent in abdominopelvic CT: comparing effectiveness with Gastrografin in the same patient. Med. J. Malaysia. 71, 322–327 (2016). (PMID: 28087955)
Makarawo, T. P. et al. Water as a contrast medium: a re-evaluation using the multidetector-row computed tomography. Am. Surg. 79, 728–733 (2013). (PMID: 23816008)
Wang, Z. J. et al. Positive enteric contrast material for abdominal and pelvic CT with automatic exposure control: what is the effect on patient radiation exposure? Eur.J. Radiol. 79, e58–62 (2011). (PMID: 10.1016/j.ejrad.2011.03.059)
Kambadakone, A.R. & Sahani, D.V. Multi-detector Computed Tomography in the Gastrointestinal System in MDCT (ed. Kalra, M.K.) 138-159 (Springer, Milano. 2008).
Elamparidhi, P., Sivaranjanie, S., Kumar, R. R., Sibhithran, R. & Kumar, A. A. Comparison of Water, Mannitol and Positive Oral Contrast for Evaluation of Bowel by Computed Tomography. International Journal of Anatomy, Radiology and Surgery 6, RO13–RO17 (2017).
de Wit, P.A.M, van Dijk, J.W., Somers, I., Beenen, L.F.M. & Bipat, S. A pilot study comparing two strategies of oral contrast in patients undergoing abdominal CT: 50 ml Télébrix Gastro + 950 ml water vs 1000 ml water only. Unpublished data.
European Commission European guidelines on quality criteria for computed tomography, EUR 16262EN. Luxembourg (2000).
Guerbet Summary of product characteristics Télébrix Gastro, 300 mg I/ml solution for injection. Guerbet, Cedex (2015).
Vandenbroucke, J. P. et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Int. J. Surg. 12, 1500–1524 (2014). (PMID: 10.1016/j.ijsu.2014.07.014)
Huda, W. & Metller, F. A. Volume CT Dose Index and Dose-Length Product Displayed during CT: What Good Are They? Radiology. 258, 236–242 (2011). (PMID: 10.1148/radiol.10100297)
Båth, M. & Månsson, L. G. Visual grading characteristics (VGC) analysis: a non-parametric rank-invariant statistical method for image quality evaluation. Br. J. Radiology. 80, 169–176 (2007). (PMID: 10.1259/bjr/35012658)
المشرفين على المادة: 0 (Contrast Media)
059QF0KO0R (Water)
تواريخ الأحداث: Date Created: 20200424 Date Completed: 20201130 Latest Revision: 20210422
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC7176630
DOI: 10.1038/s41598-020-63838-3
PMID: 32321959
قاعدة البيانات: MEDLINE
الوصف
تدمد:2045-2322
DOI:10.1038/s41598-020-63838-3