Transitioning barium enema preparation protocols to CT colonography in the modern imaging era

TL;DR

This study shows that a simplified bowel prep method, similar to barium enema, works well for CT colonography, providing good image quality.

Contribution

The study introduces a simplified bowel preparation protocol for CT colonography adapted from barium enema practices.

Findings

Over 85% of colonic segments achieved optimal tagging uniformity and distension.

More than 90% of segments had optimal residual fluid levels.

Mean scores for all parameters were below 0.3, indicating high-quality preparation.

Abstract

To evaluate the feasibility of applying a barium enema-style bowel preparation protocol to CT colonography (CTC) in clinical practice.

11 patients underwent CTC using a simplified bowel preparation protocol based on magnesium citrate, similar to that used for barium enema. Two radiologists assessed the homogeneity of fluid tagging, volume of residual fluid, and degree of colonic distension in six colonic segments (cecum, ascending, transverse, descending, sigmoid, rectum) in both supine and prone positions. Each parameter was rated on a 4-point Likert scale (0 = optimal, 3 = inadequate). The mean score and proportion of segments achieving a score of 0 were calculated.

More than 85% of segments received a score of 0 for tagging uniformity and colonic distension, and over 90% for residual fluid. Mean scores were below 0.3 for all three parameters. These findings indicate that the preparation protocol provided sufficient colonic cleansing and distension comparable to previously reported standard protocols.

A simplified bowel preparation protocol adapted from barium enema practice can be effectively applied to CT colonography, achieving clinically acceptable image quality.

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