Bowel preparation for CT-colonography: comparison of two different cleansing protocols

Comparison of cleansing effects and colonic distension observed with two polyethyleneglycol-solution (PEG) containing bowel preparation techniques prior to CT-colonography (CTC).

One hundred and three patients that received CTC in our institution were retrospectively evaluated. Fifty-one patients received preparation 1 (BP1; based on a GoLytely formulation+bisacodyl), 52 preparation 2 (BP2; based on a NuLytely formulation+bisacodyl). On multi-planar-reformatted (MPR) images, fluid residuals and colon distension were assessed in five colonic segments, from the ascending colon to the rectum.

On average, significantly (p<0.001) lower fluid residuals were assesses when using BP2 regardless of the patient position. In prone position, a significantly lower fluid level was observed in the sigmoid using bowel preparation 2. The average maximum diameter measured for the whole colon was 5.2+/-0.6 cm in prone position and 4.8+/-0.6 cm in the supine position in BP1 (p<0.01). In BP2 the average maximum diameter measured for the whole colon was 5.3+/-0.6 cm in prone position and 4.7+/-0.5 cm in supine position, respectively (p<0.001).

Overall, lower fluid residuals were scored using BP2. In both preparation groups we achieved better colonic distension in prone position. We were not able to distend the sigmoid better when insufflating air during patient repositioning.