Steffey Michele A, Zwingenberger Allison L, Daniel Leticia, Taylor Sandra L
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California.
Department of Public Health Sciences, Division of Biostatistics, School of Medicine, University of California-Davis, Davis, California.
Vet Surg. 2016 Oct;45(7):929-935. doi: 10.1111/vsu.12524. Epub 2016 Aug 4.
To investigate the effects of 3 different bowel preparation protocols on interpretation of computed tomography (CT) pneumocolonography images.
Experimental crossover design.
Intact male, hound-cross, research colony dogs (n=4).
All dogs received the 3 different bowel preparation protocols for CT pneumocolonography in the same order, with a minimum of 2 weeks between protocols. For each segment of large bowel, the subjective adequacy of bowel cleansing was assessed, residual fecal and bowel volumes were calculated, and the density of fecal material in the bowel lumen was measured. Linear mixed effect models that included a random dog effect were used to evaluate mean differences in outcome measures across protocols.
No dogs experienced any clinical problems associated with the protocols or CT pneumocolonography. Bowel cleansing was considered adequate for CT pneumocolonography interpretation for all 3 protocols. There was a significant effect of protocol on residual fecal volumes and the fecal:bowel volume ratio, with the 2 protocols that included an extended fast producing the lowest total residual fecal volumes. There was a significant effect of protocol on maximum measured density of residual fecal material with the 2 protocols including iodinated contrast having the highest density.
All protocols were sufficient for CT pneumocolonography interpretation and contrast-tagging of residual fecal material was successful with oral iopamidol administration. An at-home bowel cleansing protocol may provide adequate bowel cleansing for CT pneumocolonography image interpretation.
探讨3种不同的肠道准备方案对计算机断层扫描(CT)结肠充气造影图像解读的影响。
实验交叉设计。
完整的雄性杂交猎犬(n = 4),来自研究群体。
所有犬只按相同顺序接受3种不同的CT结肠充气造影肠道准备方案,方案之间至少间隔2周。对于大肠的每个节段,评估肠道清洁的主观充分性,计算残留粪便和肠腔容积,并测量肠腔内粪便物质的密度。使用包含随机犬效应的线性混合效应模型来评估各方案间结局指标的平均差异。
没有犬只因方案或CT结肠充气造影出现任何临床问题。所有3种方案的肠道清洁都被认为足以用于CT结肠充气造影解读。方案对残留粪便容积和粪便与肠腔容积比有显著影响,包括延长禁食的2种方案产生的总残留粪便容积最低。方案对残留粪便物质的最大测量密度有显著影响,包括碘化造影剂的2种方案密度最高。
所有方案都足以用于CT结肠充气造影解读,口服碘帕醇成功实现了残留粪便物质的对比标记。一种居家肠道清洁方案可能为CT结肠充气造影图像解读提供充分的肠道清洁。