North West Anglia NHS Foundation Trust, North West Anglia NHS Foundation Trust, Peterborough, PE3 9GZ, UK.
University of Salford, University of Salford, Manchester, M6 6PU, UK.
Radiography (Lond). 2020 Nov;26(4):e290-e296. doi: 10.1016/j.radi.2020.04.007. Epub 2020 May 4.
To investigate the impact of two Meglumine-Diatrizoate based bowel preparation regimes for computed tomography colonography (CTC) on the patient experience and image quality.
100 patients consumed Meglumine-Diatrizoate at 24 h and 12 h prior to the CTC examination. 50 patients followed regime 1 (50:50), 50 ml of Meglumine-Diatrizoate at both 24 and 12 h prior to the examination. 50 patients followed regime 2 (75:25), 75 ml of Meglumine-Diatrizoate at 24 h prior to the examination and 25 ml of Meglumine-Diatrizoate at 12 h prior to the examination. All patients completed a questionnaire to indicate the time of onset of adverse effects and when they were most severe. Five advanced practitioners assessed the image quality in a visual grading study. Visual grading characteristic (VGC) analysis was applied with regime 1 as the reference condition and regime 2 and test condition; test alpha was set at 0.05.
Image quality was assessed with successful bowel cleansing as the scoring criteria for the visual grading study. The bowel cleansing as provided by the two Meglumine-Diatrizoate regimes was revealed not to be statistically different, with the area under the VGC curve and 95% confidence intervals 0.487 (0.287, 0.701), p = 0.887. Patients taking the 75:25 bowel preparation experienced a shorter median time to the onset of adverse effects.
There was no observed difference in Image quality criteria score for the two Meglumine-Diatrizoate based bowel preparation with more predictable adverse effects of Meglumine-Diatrizoate with the 75:25 preparation.
Providing patients with a higher contrast burden 24 h prior to CTC may have a positive impact on the patient experience without compromising image quality.
为了研究两种基于泛影葡胺的肠道准备方案对计算机断层结肠成像(CTC)的患者体验和图像质量的影响。
100 名患者在 CTC 检查前 24 小时和 12 小时内服用泛影葡胺。50 名患者遵循方案 1(50:50),即检查前 24 小时和 12 小时各服用 50ml 泛影葡胺。50 名患者遵循方案 2(75:25),即检查前 24 小时服用 75ml 泛影葡胺,12 小时前服用 25ml 泛影葡胺。所有患者都填写了一份问卷,以表明不良反应的发生时间和最严重的时间。5 名高级从业者在视觉分级研究中评估了图像质量。采用视觉分级特征(VGC)分析,以方案 1 为参考条件,方案 2 和测试条件;测试α值设定为 0.05。
以视觉分级研究中成功的肠道清洁为评分标准来评估图像质量。两种泛影葡胺方案提供的肠道清洁效果没有统计学差异,VGC 曲线下面积和 95%置信区间分别为 0.487(0.287,0.701),p=0.887。服用 75:25 肠道准备的患者不良反应发生的中位数时间更短。
两种基于泛影葡胺的肠道准备方案的图像质量评分标准没有观察到差异,75:25 方案的泛影葡胺不良反应更可预测。
在 CTC 前 24 小时为患者提供更高的对比负荷可能会对患者体验产生积极影响,而不会影响图像质量。