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Image quality and patient acceptance of four regimens with different amounts of mild laxatives for CT colonography. AJR. American journal of roentgenology [AJR Am J Roentgenol] Journal article

 
TitleImage quality and patient acceptance of four regimens with different amounts of mild laxatives for CT colonography.
Author(s)Jensch S, de Vries AH, Pot D, Peringa J, Bipat S, Florie J, van Gelder RE, Stoker J 
InstitutionDepartment of Radiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1100 DD, Amsterdam, The Netherlands. s.jensch@amc.uva.nl
SourceAJR Am J Roentgenol 2008 Jul; 191(1):158-67.
MeSHAdult
Aged
Aged, 80 and over
Bisacodyl
Colonography, Computed Tomographic
Drug Administration Schedule
Female
Humans
Laxatives
Male
Middle Aged
Patient Acceptance of Health Care
Radiographic Image Enhancement
AbstractOBJECTIVE: The purpose of our study was to prospectively evaluate image quality and patient acceptance of CT colonography (CTC) with fecal tagging using different levels of catharsis.
SUBJECTS AND METHODS: Forty consecutive increased-risk patients were randomized. Group 1 received orally 20 mg of bisacodyl, group 2 received 30 mg of bisacodyl, group 3 received 20 mg of bisacodyl and 8.2 g of magnesium citrate, and group 4 received 30 mg of bisacodyl and 16.4 g of magnesium citrate. All patients used a 2-day low-fiber diet and received diatrizoate meglumine and barium for fecal tagging. One reviewer blindly scored subjective image quality (fecal tagging, amount of residual feces [liquid or solid], luminal distention, and image readability) on a 5- to 6-point scale using a 2D review technique. The mean and SD of attenuation of tagging were measured as well as the relative SD as a measure of homogeneity. Furthermore, patient acceptance (burden related to diarrhea, abdominal pain, flatulence, and overall burden) was evaluated. Ordinal regression, generalized estimating equations, and parametric and nonparametric tests were used for analysis.
RESULTS: Image readability was evaluated as good or excellent in all examinations except one in group 2 (nondiagnostic) and two in group 3 (moderate). Group 2 contained more feces than group 4 (p = 0.04). With regard to mean attenuation and homogeneity of tagging, no significant differences were observed between groups. Group 4 experienced more severe diarrhea than groups 1 and 2 and higher overall burden than groups 1 and 3 (p < 0.042).
CONCLUSION: The mildest preparation with 20 mg of bisacodyl provided good image quality of CTC images. Increasing the amount of laxatives did not improve image quality or tagging characteristics but was associated with a lower patient acceptance.
Languageeng
Pub Type(s)Journal Article
Randomized Controlled Trial
PubMed ID18562740
  
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