Sonographic image degradation after barium enema

Evaluation of a dual-purpose contrast medium for radiography and ultrasonography of the small intestine in dogs

OBJECTIVE

To evaluate a contrast medium that could be used for radiographic and ultrasonographic assessment of the small intestine in dogs.

ANIMALS

8 healthy adult Beagles.

PROCEDURES

Carboxymethylcellulose (CMC; 0.5% solution) was combined with iohexol (300 mg of iodine/mL) to yield modified contrast medium (MCM). Dogs were orally administered the first of 3 MCMs (10 mL/kg [9.5 mL of CMC/kg plus 0.5 mL of iohexol/kg]). Radiographic and ultrasonographic assessment of the small intestine followed 10 minutes after administration and every 10 minutes thereafter, until MCM was seen within the ascending colon. Minimally, 1 week elapsed between dosing of subsequent MCMs (10 mL/kg [9 mL of CMC/kg plus 1 mL of iohexol/kg and 8.5 mL of CMC/kg plus 1.5 mL of iohexol/kg]) and repeated radiography and ultrasonography.

RESULTS

Radiographic contrast enhancement of the small intestine was best with MCM that combined 8.5 mL of CMC/kg and 1.5 mL of iohexol/kg. Mean small intestinal transit time for all MCMs was 86 minutes. All MCMs did not interfere with ultrasonographic assessment of the small intestine and may have improved visualization of the far-field small intestinal walls.

CONCLUSIONS AND CLINICAL RELEVANCE

An MCM that combined 8.5 mL of 0.5% CMC/kg and 1.5 mL of iohexol/kg could be an alternative to barium or iohexol alone for contrast small intestinal radiography in dogs, especially when abdominal ultrasonography is to follow contrast radiography.

Crianças necessitam de jejum antes de ultrassonografia abdominal?

OBJETIVO: Comparar a qualidade de imagens ultrassonográficas do abdome de crianças, obtidas com e sem a instituição de jejum prévio. MATERIAIS E MÉTODOS: Trata-se de estudo prospectivo, incluindo crianças com até 12 anos de idade. Os pacientes foram examinados sequencialmente por dois utrassonografistas e as imagens foram classificadas em escores: 1 (não visualizado ou parcialmente visualizado, inadequada para diagnóstico); 2 (suficientes para diagnóstico); 3 (excelentes). As imagens foram ainda classificadas como "diagnósticas" ou "não diagnósticas". RESULTADOS: Foram examinados 77 pacientes, sendo 47 meninos e 30 meninas, com idades entre 0 e 12 anos (mediana de 1 ano). Jejum se mostrou vantajoso de forma estatisticamente significativa apenas na avaliação da vesícula biliar, por apenas um dos avaliadores (p = 0,032). Depois de agrupadas em "diagnóstica" ou "não diagnóstica", nenhuma diferença foi observada entre os grupos. CONCLUSÃO: A instituição de jejum não afetou de forma significativa a qualidade das imagens de ultrassonografias abdominais obtidas em crianças.

Is fasting a necessary preparation for abdominal ultrasound?

OBJECTIVE: To study the effect of fasting on the technical success of abdominal ultrasound examination. METHODS: In a randomized, prospective study, 150 patients for abdominal ultrasound were divided into two groups of 75 patients each with instructions to fast for six hours or have normal breakfast respectively. RESULT: The technical success of the abdominal ultrasound performed by radiologists blinded to the instruction did not differ significantly between the groups. CONCLUSION: It appears that routine fasting before abdominal ultrasound is not necessary.