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目的分析大剂量等渗甘露醇和泛影葡胺口服液在多层螺旋CT小肠造影(multislice CT Enterography,MSCTE)表现,总结MSCTE的最佳造影剂。方法60例正常体检者随机分配成二组,一组30例服用2000ml浓度2.5%甘露醇口服液,另一组30例服用2000ml浓度2.5%泛影葡胺口服液,二组均肌注20mg山莨菪碱(654-2),15～20min后行螺旋CT扫描,通过对比横断面及多平面重建图像(mul-tiplanar reform ation,MPR),测量二组小肠肠腔宽度、肠壁厚度及肠壁密度,进行统计学分析。结果二组体检者反映甘露醇口感甜,容易服用,泛影葡胺口感略涩。在小肠肠腔宽度的比较上,二组无明显统计学意义,甘露醇组与泛影葡胺组的肠腔宽度无明显差别。在肠壁厚度的比较上,二组无明显统计学差异,肠壁厚度均在3mm左右。在肠壁密度的比较上,二组有统计学意义(P<0.05),甘露醇比较真实反映肠壁密度,泛影葡胺容易形成伪影造成肠壁密度偏高。结论2.5%等渗甘露醇溶液能充分扩张小肠肠管,较好地显示肠壁厚度及真实反映肠壁的密度,是比较理想的MSCTE造影剂。
Objective To analyze the performance of large dose isotonic mannitol and diatrizoate megluminemide in multislice CT Enterography (MSCTE) and to summarize the best contrast agent for MSCTE. Methods 60 normal subjects were randomly divided into two groups. One group of 30 patients took 2000ml 2.5% mannitol oral solution while the other 30 patients took 2000ml 2.5% diatrizoate oral solution. Both groups received intramuscular injection of 20mg mountain Scopolamine (654-2) and spiral CT scans were performed 15 to 20 minutes later. The width of the intestinal lumen, the thickness of the intestinal wall and the intestinal wall were measured by comparing the cross-sectional images and the mul-tiplanar reconstruction (MPR) Density, statistical analysis. The results of two groups of patients to reflect the taste of mannitol sweet, easy to take, diacetate meglumine slightly astringent. In the small intestine lumen width comparison, the two groups had no statistical significance, mannitol group and the diatrizoate group intestinal lumen width no significant difference. In the comparison of intestinal wall thickness, no significant difference between the two groups, the thickness of intestinal wall are about 3mm. The intestinal wall density in the comparison, the two groups were statistically significant (P <0.05), mannitol more truly reflect the intestinal wall density, diatrizoate meglumine easy to form artifacts resulting in high bowel wall density. Conclusion 2.5% isotonic mannitol solution can fully expand the intestine of small intestine, and better display the thickness of the intestinal wall and reflect the true density of the intestinal wall, which is an ideal MSCTE contrast agent.