Jobling C, Halligan S, Bartram C
Department of Radiology, City Hospital, Nottingham, UK.
Eur Radiol. 1999;9(4):706-10. doi: 10.1007/s003300050737.
In certain situations it is preferable to perform small bowel examination using water-soluble contrast agents. Generally, ionic agents are used, but non-ionic agents may be an alternative in certain circumstances. We retrospectively reviewed a consecutive series of small bowel examinations using non-ionic media in order to determine their efficacy. A total of 52 water-soluble non-ionic small bowel follow-through examinations were performed in 42 patients using 100 ml iohexol. Indications for the study and the reasons why barium sulphate suspensions were contraindicated were established. Studies were assessed for radiographic quality and clinical findings were noted, and comparison was made with operative findings and clinical outcome. Obstruction was diagnosed in 12 examinations and the radiological findings were confirmed in all 7 patients surgically treated. Fistulae were identified in 11 examinations and the radiological findings were confirmed in all 8 patients who were treated by laparotomy. Additionally, at laparotomy no obstruction or fistula was found in the 5 patients in whom prior contrast examination had been negative. Non-ionic water-soluble follow-through examination is easily performed and well tolerated, allowing accurate diagnosis of obstruction and fistula when barium suspensions are contraindicated.
在某些情况下，使用水溶性造影剂进行小肠检查更为可取。一般来说，使用离子型造影剂，但在某些情况下非离子型造影剂可能是一种替代选择。我们回顾性分析了一系列连续使用非离子型造影剂进行的小肠检查，以确定其有效性。42例患者共进行了52次使用100毫升碘海醇的水溶性非离子型小肠钡剂灌肠检查。明确了研究的适应证以及硫酸钡混悬液禁忌使用的原因。对检查的影像学质量进行评估，记录临床发现，并与手术结果和临床结局进行比较。12次检查诊断为肠梗阻，所有7例接受手术治疗的患者的影像学表现均得到证实。11次检查发现瘘管，所有8例接受剖腹手术治疗的患者的影像学表现均得到证实。此外，在5例先前造影检查结果为阴性的患者剖腹手术中未发现梗阻或瘘管。非离子型水溶性钡剂灌肠检查操作简便，耐受性良好，在硫酸钡混悬液禁忌使用时可准确诊断梗阻和瘘管。
