Dataset Information

Evaluation of the performance of two neutral oral contrast agents in computed tomography enterography: A randomized controlled trial.

ABSTRACT: OBJECTIVE:To compare the performances, tolerability and acceptability of mannitol and polyethylene glycol (PEG) as oral contrast agents in patients undergoing computed tomography enterography (CTE). METHODS:Patients aged 18-75?years indicated for CTE were randomized to receive either mannitol or PEG as contrast agents. The coronal reconstructed images of each abdominal quadrant were assessed for maximum distention, proportion of distended bowel loops, presence of inhomogeneous contents and visibility of the small bowel wall. Overall subjective imaging quality assessment and patients' tolerability and acceptability were recorded. RESULTS:Seventy patients were enrolled and randomized into two groups. In the per-protocol analysis, no significant differences in imaging quality was found in bowel distention maximum diameter, wall visibility and intestinal homogeneity (all P?>?0.05). The mean nausea score was lower in the mannitol group (0 [0-0] vs 1.0 [0-3.0], P?

SUBMITTER: Zheng MQ

PROVIDER: S-EPMC7065060 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Evaluation of the performance of two neutral oral contrast agents in computed tomography enterography: A randomized controlled trial.

Zheng Meng Qi MQ Zeng Qing Shi QS Yu Yong Quan YQ Ji Rui R Li Yue Yue YY Zhang Ming Ming MM Sun Yi Ning YN Li Li Xiang LX Zuo Xiu Li XL Yang Xiao Yun XY Li Yan Qing YQ

Journal of digestive diseases 20200115 2

<h4>Objective</h4>To compare the performances, tolerability and acceptability of mannitol and polyethylene glycol (PEG) as oral contrast agents in patients undergoing computed tomography enterography (CTE).<h4>Methods</h4>Patients aged 18-75 years indicated for CTE were randomized to receive either mannitol or PEG as contrast agents. The coronal reconstructed images of each abdominal quadrant were assessed for maximum distention, proportion of distended bowel loops, presence of inhomogeneous con ...[more]

PMID: 31825554

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Project description:Background:The treatment goal of Crohn's disease (CD) has moved towards achieving mucosal healing, resolution of transmural inflammation, and normalization of biomarkers. The purpose of this study was to evaluate how well computed tomography enterography (CTE) and fecal calprotectin (FC) correlated with endoscopic activity in newly diagnosed patients with CD and after 1 year of therapy. Methods:Consecutive patients with newly diagnosed CD were evaluated by endoscopy, CTE, and FC at diagnosis and 12 months after beginning immunosuppression. Endoscopic severity was assessed using the Simplified Endoscopic Score for Crohn's Disease (SES-CD). Biomarkers, clinical indexes, and FC were recorded on the day of ileocolonoscopy at diagnosis and 1 year after diagnosis. We adapted a CTE score for disease activity based on radiological signs of inflammation (i.e. mural thickness, mural hyperenhancement, mesenteric fat proliferation, mesenteric fat densification, comb sign, presence of strictures, fistulas, abscesses, ascites, and lymphadenopathy). Correlations between endoscopy, CTE, and FC were assessed using Spearman's rank correlation. Results:A total of 29 patients (48% women; median age 30 (24.5-35.5) years) were included in this prospective cohort. CTE findings significantly correlated with endoscopic findings. Endoscopic remission (ER) at 1-year follow up significantly correlated with improvement in mural hyperenhancement (p = 0.004), mesenteric fat densification (p = 0.001), comb sign (p = 0.004), and strictures (p = 0.008) in CTE. None of the CTE findings improved in patients without ER. FC correlated with SES-CD (rs = 0.696, p < 0.001) and with CTE features of inflammation (rs = 0.596, p < 0.001). A cut-off of 100 µg/g predicted ER with 92% sensitivity, 65% specificity, and 83% accuracy (area under curve 0.878, p < 0.001). Conclusions:CTE findings and FC levels correlated with endoscopic activity in CD both at diagnosis and at 1-year follow up. These two noninvasive markers of disease activity may be used as an alternative to endoscopy to monitor disease response to therapy.

Project description:BackgroundThe management of the use of iodinated contrast agents (ICA) in the computed tomography (CT) has clinical and financial impacts; however, the approaches in the current research setting have limitations with regard to their exploration of the theme. This work describes the application of the stages of a process of business intelligence (BI), from the formulation of business questions, the building of a research database, and the adaptation of a multidimensional model, to the creation of dashboards to give support to the decision-making process in a hospital. This research aims to apply and document a BI process that provides support to the decision making of managers, so the use of ICA can be better managed, allowing for the identification of situations in which the material was wasted using a study applied to the hospital field.MethodsAn applied exploratory research with a quantitative approach in a database made up by 24 variables and 35,388 records extracted from the RIS (Radiology Information System) that is used by the General Hospital of Porto Alegre-HCPA. The software used, supplied by AGFA Healthcare, were the Qdoc system (version 6.2.0) and the Impax BI (Version 11.1.1) for, respectively, data entry and data exploration. At the end of the process, a total of 48 variables was considered.ResultsThe BI process applied allowed for the identification of situations in which ICA was being wasted during the operationalization of the volume/mass ratio of the agent injected in the patient. It also offered the necessary substantiation for the managers to formulate plans, actions, and controls associated to the use of the material. This work made it possible to diminish in 15.65% the total consumption of ICA injected in the patients who underwent the CTAB1 exam (full CT scan of the abdomen), with a projected economy of US$ 10,039.95, for the performance of this exam from 2020 on. The measuring of the impact and the relevance of the process was 99.6% positive, according to the evaluation of the managers.ConclusionsThis research generated clinical and financial benefits for the HCPA, a positive evaluation by the managers and the generation of new knowledge, which can be shared with other public or private health organizations.

Dataset Information

Evaluation of the performance of two neutral oral contrast agents in computed tomography enterography: A randomized controlled trial.

Publications

Evaluation of the performance of two neutral oral contrast agents in computed tomography enterography: A randomized controlled trial.

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