评估西甲硅油包裹的纤维素作为腹部CT的阴性口服对比剂。

Evaluation of simethicone-coated cellulose as a negative oral contrast agent for abdominal CT.

作者信息

Sahani Dushyant V, Jhaveri Kartik S, D'souza Roy V, Varghese Jose C, Halpern Elkan, Harisinghani Mukesh G, Hahn Peter F, Saini Sanjay

机构信息

Department of Radiology, Division of Abdominal Imaging and Intervention, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114, USA.

出版信息

Acad Radiol. 2003 May;10(5):491-6. doi: 10.1016/s1076-6332(03)80057-0.

DOI:10.1016/s1076-6332(03)80057-0

PMID:12755536

Abstract

RATIONALE AND OBJECTIVES

Because of the increased clinical use of computed tomography (CT) for imaging the abdominal vasculature and urinary tract, there is a need for negative contrast agents. The authors undertook this study to assess the suitability of simethicone-coated cellulose (SCC), which is approved for use as an oral contrast agent in sonography, for use as a negative oral contrast agent in abdominal CT.

MATERIALS AND METHODS

This prospective study involved 40 adult patients scheduled to undergo abdominal CT for the evaluation of hematuria. Prior to scanning, 20 subjects received 800 mL of SCC and 20 received 800 mL of water as an oral contrast agent. Imaging was performed with a multi-detector row helical scanner in two phases, according to the abdominal CT protocol used for hematuria evaluation at the authors' institution. The first, "early" phase began an average of 15 minutes after the ingestion of contrast material; the second, "late" phase began an average of 45 minutes after the ingestion of contrast material. Blinded analysis was performed by three abdominal radiologists separately, using a three-point scale (0 = poor, 1 = acceptable, 2 = excellent) to assess the effectiveness of SCC for marking the proximal, middle, and distal small bowel. Average scores for enhancement with SCC and with water were obtained and compared. Statistical analysis was performed with a Wilcoxon signed-rank test.

RESULTS

SCC was assigned higher mean scores than water for enhancement in each segment of the bowel, both on early-phase images (0.8-1.35 for SCC vs 0.6-1.1 for water) and on late-phase images (1.1-1.4 vs 0.81-0.96). Bowel marking with SCC, particularly in the jejunum and ileum, also was rated better than that with water in a high percentage of patients. The differences between the scores for water and for SCC, however, were not statistically significant (P > .05).

CONCLUSION

SCC is effective as a negative oral contrast agent for small bowel marking at CT.

摘要

原理与目的

由于计算机断层扫描（CT）在腹部血管系统和泌尿系统成像中的临床应用增加，因此需要阴性对比剂。作者进行了这项研究，以评估已被批准用作超声检查口服对比剂的西甲硅油包裹纤维素（SCC）作为腹部CT阴性口服对比剂的适用性。

材料与方法

这项前瞻性研究纳入了40名计划接受腹部CT以评估血尿的成年患者。扫描前，20名受试者接受800毫升SCC，20名受试者接受800毫升水作为口服对比剂。根据作者所在机构用于血尿评估的腹部CT方案，使用多排螺旋扫描仪分两个阶段进行成像。第一个“早期”阶段在摄入对比剂后平均15分钟开始；第二个“晚期”阶段在摄入对比剂后平均45分钟开始。由三名腹部放射科医生分别进行盲法分析，使用三点量表（0 = 差，1 = 可接受，2 = 优）评估SCC标记近端、中段和远端小肠的有效性。获得并比较SCC和水增强的平均分数。采用Wilcoxon符号秩检验进行统计分析。

结果

在早期图像（SCC为0.8 - 1.35，水为0.6 - 1.1）和晚期图像（SCC为1.1 - 1.4，水为0.81 - 0.96）上，SCC在肠道各段增强方面的平均分数均高于水。在高比例患者中，SCC对肠道的标记，尤其是在空肠和回肠，也比水的标记效果更好。然而，水和SCC的分数差异无统计学意义（P > 0.05）。