Evaluation of the Performance of Neutral Oral Contrast Materials: A Computered Tomography Enterography Study

Abstract

Objectives:

We aimed to compare the performances of two neutral oral contrast agents, polyethylene glycol (PEG) and lactulose solution.

Materials and Methods:

The computed tomography enterography (CT-E) data of 54 consecutive patients that either used lactulose solution or PEG were retrospectively analyzed and measurements were made by the mutual agreement of 2 radiologists. The radiological records of patients were also evaluated by including technician’s notes regarding patient compliance with instructions and a questionnaire to be filled out by the patients about oral contrast agent related discomfort. The intestinal distension and patient’s tolerance were compared between the lactulose solution and PEG groups. The relationship between the lactulose solution and PEG groups was analyzed using the Student’s t-test for continuous variables with normal distribution, and the Mann-Whitney U test for continuous variables without normal distribution. The relationship between the lactulose group and the PEG group in terms of patient tolerance was evaluated using the chi-square test.

Results:

The intestinal distention provided by the lactulose group in the duodenal segments was superior to that of the PEG group (p<0.001). We observed no significant difference in the jejunum and ileum between two oral contrast agents (p=0.747 and p=0.662). Lactulose was better tolerated when compared to PEG (likelihood ratio=7.38, p=0.025).

Conclusion:

Lactulose is the preferred oral contrast agent for CT-E studies due to its achievement in duodenal distension and its better tolerance.