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Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens

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Published on: April 18, 2013

Water as a contrast medium: a re-evaluation using the multidetector-row computed tomography.

Tafadzwa P Makarawo¹, Edsa Negussie, Sachit Malde

¹Department of Surgery, Providence Hospital and Medical Centers, Southfield, Michigan, USA. taffyowm@yahoo.com

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|July 3, 2013

Summary

Water is an effective negative contrast agent for computed tomography (CT) scans, offering improved image quality. Modern CT technology supports its use, suggesting a re-evaluation for clinical practice.

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Area of Science:

Radiology and Medical Imaging
Gastrointestinal Imaging
Computed Tomography (CT)

Background:

Oral water as an intraluminal negative contrast medium can enhance CT image quality by reducing artifacts.
Previous limitations in water's clinical use were due to rapid bowel absorption, not aligning with older imaging speeds.
Advances in multidetector-row CT (MDCT) necessitate re-evaluating water's efficacy as a contrast agent.

Purpose of the Study:

To compare image quality, specifically luminal distention and clarity, between pancreas protocol CT (PPCT) using oral water and conventional positive oral contrast CT.
To assess the effectiveness of water as a negative contrast agent in modern CT technology.

Main Methods:

Retrospective review of 66 patients who underwent both PPCT with oral water and conventional oral contrast abdominal CT.
Independent radiologist scoring of hollow viscus distention and mural detail using a Likert scale.
Statistical analysis including Wilcoxon-signed rank test for image quality, Student's t test for radiation dose, and Spearman's correlation for interrater reliability.

Main Results:

No significant difference in mean radiation dosage between the two protocols.
PPCT with water demonstrated statistically significant improvements in clarity and distention in the stomach and duodenum compared to conventional contrast.
Water provided better or equal bowel distention and clarity compared to routine barium contrast, supporting its efficacy with current CT technology.

Conclusions:

Modern CT technology enables water to be an effective intraluminal negative contrast medium.
Water offers comparable or superior image clarity and luminal distention in the stomach and duodenum versus traditional contrast agents.
The findings support reconsidering the clinical application of water as a contrast agent in CT imaging.