Abstract
Objectives To determine the most preferable endoluminal contrast agent among mannitol, polyethylene
glycol (PEG), iohexol, and water by comparing various qualitative (distension, fold
visibility, and homogeneity) and quantitative parameters (distension) along with artifacts
and patient feedback for computed tomography enterography (CTE).
Methods This was a prospective study including 120 patients of age more than or equal to
18 years who were randomized equally into four groups. Group 1 was given 1500 mL of
3% mannitol solution, group 2 was given 1500 mL of PEG, group 3 was given 20 mL of
iohexol dissolved in 1500 mL of water, and group 4 was given 1500 mL of plain water.
CTE was done and images were evaluated in axial and coronal planes. Various quantitative
and qualitative parameters were taken at the level of second part of duodenum, jejunum,
ileum and ileocecal junction (ICJ). Artifacts and patient feedback were also taken
into consideration.
Results The quantitative distension and grading, qualitative distension, fold visibility,
and homogeneity of the second part of duodenum, jejunum at the level of superior mesenteric
artery, inferior mesenteric artery and renal artery on both sides of abdomen, ileum
at the level of aortic bifurcation, common iliac bifurcation, and deep pelvis on both
sides of abdomen and ICJ were significantly more in PEG group as compared with mannitol
group, followed by iohexol and water group. The results were calculated by ANOVA test
using p-value. In terms of patient feedback and artifacts, water was the best agent.
Conclusions PEG is the most suitable contrast agent to carry out CTE. Distension, fold visibility,
and homogeneity are the essential features for a better diagnostic outcome of CTE,
which was better with PEG.
Keywords
Intestine - Iohexol - Mannitol - multidetector computed tomography - polyethylene
glycols - radiology
