Laohawiriyakamol Kamolmas, Laothamatas Jiraporn, Chanyongvorakul Eupar
Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
J Med Assoc Thai. 2007 May;90(5):903-12.
Computed tomography (CT) is a widely available modality in evaluating benign and malignant diseases of the esophagus. To date, there is no substantial consensus on the optimal and widely available method for opacifying the esophageal lumen exists for CT OBJECTIVE: The present study was performedf or complete and continuous opacification of the esophagus using two developed oral contrast materials and a commercial barium paste formulated for CT MATERIAL AND METHOD: One hundred and seven adult patients were sent for spiral routine CT scan of the chest (Light speed plus; General Electric Medical System, Milwaukee, Wis., USA) to evaluate variety of clinical conditions at Ramathibodi Hospital. They were divided into three groups. Two developed oral contrast materials, 1.5%(wt/vol) carboxy-methyl cellulose sodium paste containing 2%(wt/vol) barium sulfate and 5.5%(wt/vol) potato starch containing 2%(wt/vol) barium sulfate, and a commercial barium paste were randomly administered Data collection and analysis of the CT findings were performed double blindly.
The patients undergoing CT scan of the chest were performed with one of the oral contrast material. No streak artifact was present in any of the CT slices. Of the grade 1, contrast present without luminal distension and grade 2, contrast present with luminal distension, 1.5% CMC containing 2% barium sulfate was opacified in 36.48% and 17.45/o, respectively. Opacification with 5.5% starch containing 2% barium sulfate was of 36.41% and 19.71% while that of 3% commercial barium paste was of 36.68% and 27.54%, respectively. Acceptable taste was also achieved However, mild to moderate difficulty in swallowing occurred in 35% with no medication or intervention needed
All oral contrast materials tested were less continuous and did not opacified the esophageal lumen as much when compared with the prior studies. However, acceptable taste, only mild to moderate difficulty in swallowing during the procedure, and significantly cheaper cost enable them to be used in selected cases in CT scan of the neck, chest, and upper abdomen for clarification of the problem areas.
计算机断层扫描（CT）是评估食管良恶性疾病时广泛应用的一种检查方式。迄今为止，对于CT检查中使食管腔显影的最佳且广泛可用的方法尚无实质性共识。
本研究使用两种自行研制的口服对比剂和一种市售的CT用钡糊剂对食管进行完全且持续的显影。
107例成年患者被送去进行胸部螺旋常规CT扫描（Light speed plus；美国威斯康星州密尔沃基市通用电气医疗系统公司），以评估拉玛蒂博迪医院的各种临床情况。他们被分为三组。两种自行研制的口服对比剂，即含2%（重量/体积）硫酸钡的1.5%（重量/体积）羧甲基纤维素钠糊剂和含2%（重量/体积）硫酸钡的5.5%（重量/体积）马铃薯淀粉糊剂，以及一种市售钡糊剂被随机给予。CT检查结果的数据收集和分析采用双盲法进行。
接受胸部CT扫描的患者使用了其中一种口服对比剂。所有CT图像切片均未出现条纹伪影。在1级（有对比剂但管腔未扩张）和2级（有对比剂且管腔扩张）中，含2%硫酸钡的1.5%羧甲基纤维素钠的显影率分别为36.48%和17.45%。含2%硫酸钡的5.5%淀粉的显影率分别为36.41%和19.71%，而3%市售钡糊剂的显影率分别为36.68%和27.54%。口感也尚可接受。然而，35%的患者出现轻度至中度吞咽困难，无需药物治疗或干预。
与先前的研究相比，所有测试的口服对比剂显影的连续性较差，且对食管腔的显影程度不足。然而，其口感尚可接受，检查过程中仅出现轻度至中度吞咽困难，且成本显著更低，这使得它们可用于颈部、胸部和上腹部CT扫描的特定病例，以明确问题区域。
