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Upper gastrointestinal tract and abdomen: water as an orally administered contrast agent for helical CT
T C Winter1, J D Ager, H V Nghiem
1Department of Radiology, University of Washington Medical Center, Seattle 98195, USA.
Purpose:
To evaluate the use of orally administered water as a negative contrast agent and intravenously administered glucagon in helical computed tomography (CT) of the upper abdomen.
Materials And Methods:
Ninety-eight adult patients underwent 102 helical CT examinations. Patients received 700 mL of water orally 30 minutes before and another 350 mL of water orally with 1 mg of glucagon intravenously just before CT. The amount of water actually ingested was recorded. Luminal distention at five sites was graded on a three-point scale; depiction of six normal anatomic structures was evaluated.
Results:
Luminal distention improved with the amount of water ingested in four of the five sites (P < .03 in three sites). Depiction of all six normal anatomic structures improved with increasing luminal distention (P < .001). The normal duodenal papilla was seen in 42% (83 of 198) of the examinations. Of 87 patients who had previously undergone CT with positive oral contrast agents, 89% (n = 77) preferred the water, 11% (n = 10) had no preference, and none preferred the positive agent (P < .001). Upper gastrointestinal tract abnormalities were easily recognized and depicted.
Conclusion:
Water is an efficacious negative contrast agent for evaluation of the upper gastrointestinal tract during helical CT.