Depiction of normal gastrointestinal anatomy with MDCT: Comparison of low- and high-attenuation oral contrast media

PurposeTo compare low- and high-attenuation oral contrast media for depiction of normal gastrointestinal anatomy with multidetector-row computed tomography (MDCT).Materials and methodsA prospective, randomized study of 90 consecutive patients without known or suspected gastrointestinal disease was conducted after the approval of our Institutional Review Board. All patients underwent IV contrast-enhanced abdominal and pelvic CT scans after oral administration of 900 ml of either low- or high-attenuation barium sulphate suspension. Using a five-point scale, two radiologists independently graded distention and wall visualization of stomach, duodenum, jejunum, and ileum. The degree of distention and wall visualization was compared using Mann–Whitney U-test.ResultsDuodenal, jejunal and ileal distention (p < 0.05, <0.001, <0.001, respectively) and wall visualization (p < 0.05, <0.01, <0.05, respectively) scores with low-attenuation contrast medium were significantly higher than those with high-attenuation barium sulphate preparation, for reader 1. Duodenal and jejunal wall visualization scores with low-attenuation contrast medium (p < 0.05, <0.01, respectively) were significantly higher than those with high-attenuation contrast medium, for reader 2. Interobserver agreement was fair to good for both distention (κ-range: 0.41–0.74) and wall visualization (κ-range: 0.48–0.71).ConclusionMDCT with low-attenuation contrast medium provides distention and wall visualization of the GI tract that is equal or better than high-attenuation contrast medium.