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The Impact of Enteric Contrast on Radiologist Confidence in Intravenously Enhanced MDCT of the Abdomen and Pelvis: A Randomized Controlled Trial

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DOI: 10.4236/act.2014.32004    4,321 Downloads   5,333 Views   Citations

ABSTRACT

After Institutional Review Board approval, 109 patients ≥ 18 years old undergoing intravenously enhanced Computed Tomography (CT) of the abdomen and pelvis were prospectively enrolled and randomized into two arms. Patients with a history of inflammatory bowel disease, Crohn disease and ulcerative colitis were excluded. The control arm received routine enteric contrast and intravenous contrast. The experimental arm did not receive oral contrast, but received the standard dose of intravenous (IV) contrast. One of four experienced body radiologists reviewed the studies and rated his/her confidence on a scale of 1 (no confidence) to 10 (all confident findings have been made). Confidence levels were compared between groups. The 109 subjects were distributed 54 (49.5%) in the control arm and 55 (50.5%) in the experimental arm. The average confidence level in the control arm was 8.7 ± 0.9 versus 8.4 ± 1.1 in the experimental arm, which is not statistically significant (p value = 0.09). Among radiologists, the average confidence levels ranged from 6 - 10 in the control arm and 7 - 10 in the experimental arm. No examinations were repeated for technical considerations in either group. No studies were repeated in the experimental group in order to administer oral contrast. When each radiologist was compared to the others, there were no differences in confidence level between pairs in the control arm; however, there were statistically significant differences in confidence level among three pairs of radiologists for the experimental arm. There was no statistically significant difference in radiologist confidence level between intravenously enhanced abdomen and pelvis CTs with enteric contrast and without enteric contrast.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Garcia, C. , Boe, S. , Coughlin, B. , O’Sullivan, D. , Moote, D. , O’Loughlin, M. , Jajoo, D. and Lee, S. (2014) The Impact of Enteric Contrast on Radiologist Confidence in Intravenously Enhanced MDCT of the Abdomen and Pelvis: A Randomized Controlled Trial. Advances in Computed Tomography, 3, 18-23. doi: 10.4236/act.2014.32004.

References

[1] Laituri, C.A., Fraser, J.D., Aguayo, P., Fike, F.B., Garey, C.L., Sharp, S.W., Ostlie, D.J. and St Peter, S.D. (2011) The Lack of Efficacy for Enteric Contrast in the Diagnosis of Appendicitis by Computed Tomography. Journal of Surgical Research, 170, 100-103.
http://dx.doi.org/10.1016/j.jss.2011.02.017
[2] Anderson, S.W., Rhea, J.T., Milch, H.N., Ozonoff, A., Lucey, B.C. and Soto, J.A. (2010) Influence of Body Habitus and Use of Enteric Contrast on Reader Confidence with Suspected Appendicitis Using 64 MDCT. Emergency Radiology, 17, 445-453.
http://dx.doi.org/10.1007/s10140-010-0875-x
[3] Latifi, A., Labruto, F., Kaiser, S., Ullberg, U., Sundin, A. and Torkzad, M.R. (2011) Does Enteral Contrast Increase the Accuracy of Appendicitis Diagnosis? Radiologic Technology, 82, 294-299.
[4] Anderson, S.W., Soto, J.A., Lucey, B.C., Ozonoff, A., Jordan, J.D., Ratevosian, J., Ulrich, A.S., Rathlev, N.K., Mitchell, P.M., Rebholz, C., Feldman, J.A. and Rhea, J.T. (2009) Abdominal 64-MDCT for Suspected Appendicitis: The Use of Enteric and IV Contrast Material versus IV Contrast Material Only. AJR, 193, 1282-1288.
http://dx.doi.org/10.2214/AJR.09.2336
[5] Holmes, J.F., Offerman, S.R., Chang, C.H., Randel, B.E., Hahn, D.D., Frankovsky, M.J. and Wisner, D.H. (2004) Performance of Helical Computed Tomography without Enteric Contrast for the Detection of Gastrointestinal Injuries. Annals of Emergency Medicine, 43, 120-128.
http://dx.doi.org/10.1016/S0196-0644(03)00727-3
[6] Lane, M.J., Katz, D.S., Ross, B.A., Clautice-Engle, T.L., Mindelzum, R.E. and Jeffrey Jr., R.B. (1997) Unenhanced Helical CT for suspected Acute Appendicitis. AJR, 168, 405-409.
http://dx.doi.org/10.2214/ajr.168.2.9016216
[7] Paulson, E.K. and Coursey, C.A. (2009) CT Protocols for Acute Appendicitis: Time for Change. AJR, 193, 1268-1271.
http://dx.doi.org/10.2214/AJR.09.3313
[8] Lee, S.Y., Coughlin, B., Wolfe, J.M., Polino, J., Blank, F.S. and Smithline, H.A. (2006) Prospective Comparison of Helical CT of the Abdomen and Pelvis without and with Enteric Contrast in Assessing Acute Abdominal Pain in Adult Emergency Department Patients. Emergency Radiology, 12, 150-157.
http://dx.doi.org/10.1007/s10140-006-0474-z
[9] Harieaswar, S., Rajesh, A., Griffin, Y., Tygi, R. and Morgan, B. (2009) Routine Use of Positive Enteric Contrast Material Is Not Required for Oncology Patients Undergoing Follow-Up Multidetector CT. Radiology, 250, 246-253.
http://dx.doi.org/10.1148/radiol.2493080353
[10] Grainger, R.G. and Thomas, A.M.K. (1999) Textbook of Contrast Media. 2nd Edition, Isis Medical Media Ltd., Oxford, 135-148.
[11] Wang, Z.J., Chen, K.S., Gould, R., Coakley, F.V., Fu, Y. and Yeh, B.M. (2011) Positive Enteric Contrast Material for Abdominal and Pelvic CT with Automatic Exposure Control: What Is the Effect on Patient Radiation Exposure? European Journal of Radiology, 79, e58-62.
http://dx.doi.org/10.1016/j.ejrad.2011.03.059

  
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