HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Shinners, T. J. Articles by Olsen, C. H. Search for Related Content PubMed PubMed Citation Articles by Shinners, T. J. Articles by Olsen, C. H. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Patient-Controlled Room Air Insufflation Versus Automated Carbon Dioxide Delivery for CT Colonography

¹ Department of Radiology, University of Wisconsin Medical School, Clinical Science Center, 600 Highland Ave., Madison, WI 53792.
² Ministry Health-St. Mary's Hospital, Rhinelander, WI 54501.
³ Department of Radiology, Uniformed Services University of the Health Sciences, Bethesda, MD.
⁴ Biostatistics Consulting Center, Uniformed Services University of the Health Sciences, Bethesda, MD.

OBJECTIVE. Our objective was to prospectively compare colonic distention and patient comfort at screening CT colonography (CTC) with patient-controlled room air (RA) insufflation versus automated carbon dioxide (CO₂) delivery.

SUBJECTS AND METHODS. Two hundred eight adults undergoing CTC were randomized to RA or CO₂ (104 per method). Colonic distention was prospectively assessed by segment using a 4-point scale (1 = optimal, 2 = adequate, 3 = inadequate, 4 = collapsed). Adequacy of combined supine/prone segmental evaluation was also recorded. Patients provided discomfort ratings on a 0-10 scale (0-1 = none/insignificant, 2-3 = minimal, 4-6 = intermediate, 7-10 = significant) before, during, and after the procedure.

RESULTS. No significant differences in segmental distention were observed in the prone position between techniques. In the supine position, CO₂ resulted in significantly greater distention in the sigmoid, descending, and transverse segments (p < 0.01). After combined supine/prone assessment, two/104 (1.9%) and three/104 (2.9%) patients were judged to have an inadequately evaluated segment on RA and CO₂, respectively (four sigmoid, one transverse). Mean discomfort scores for RA and CO₂ were 3.97 and 5.08 during the examination (p < 0.01); 0.91 and 0.42 immediately after (p < 0.01); 0.51 and 0.25 15 min later (p < 0.05); and 0.15 and 0.04 2 hours later (p < 0.01), respectively. During active distention, 19 (18.3%) and 33 (31.7%) patients reported significant transient discomfort with RA and CO₂, respectively (p < 0.05). Beyond 15 min, only two (1.9%) patients with RA and no patients with CO₂ had a discomfort level higher than 3.

CONCLUSION. Although patient-controlled RA insufflation and automated CO₂ delivery each resulted in negligible postprocedure discomfort and reliable colonic distention, CO₂ was better for both categories.

Keywords: colon • CT colonography • CT technique • screening

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				R. L. Van Uitert, R. M. Summers, J. M. White, K. K. Deshpande, J. R. Choi, and P. J. Pickhardt Temporal and Multiinstitutional Quality Assessment of CT Colonography Am. J. Roentgenol., November 1, 2008; 191(5): 1503 - 1508. [Abstract] [Full Text] [PDF]

				R. M. Summers, L. R. Handwerker, P. J. Pickhardt, R. L. Van Uitert, K. K. Deshpande, S. Yeshwant, J. Yao, and M. Franaszek Performance of a Previously Validated CT Colonography Computer-Aided Detection System in a New Patient Population Am. J. Roentgenol., July 1, 2008; 191(1): 168 - 174. [Abstract] [Full Text] [PDF]

				S. Y. Kim, S. H. Park, E. K. Choi, S. S. Lee, K. H. Lee, J. C. Kim, C. S. Yu, H. C. Kim, A. Y. Kim, and H. K. Ha Automated Carbon Dioxide Insufflation for CT Colonography: Effectiveness of Colonic Distention in Cancer Patients with Severe Luminal Narrowing Am. J. Roentgenol., March 1, 2008; 190(3): 698 - 706. [Abstract] [Full Text] [PDF]

				K. K. Deshpande, R. M. Summers, R. L. Van Uitert, M. Franaszek, L. Brown, A. J. Dwyer, J. G. Fletcher, J. R. Choi, and P. J. Pickhardt Quality Assessment for CT Colonography: Validation of Automated Measurement of Colonic Distention and Residual Fluid Am. J. Roentgenol., December 1, 2007; 189(6): 1457 - 1463. [Abstract] [Full Text] [PDF]

				P. J. Pickhardt Screening CT Colonography: How I Do It Am. J. Roentgenol., August 1, 2007; 189(2): 290 - 298. [Abstract] [Full Text] [PDF]

				T. Mang, A. Maier, C. Plank, C. Mueller-Mang, C. Herold, and W. Schima Pitfalls in Multi-Detector Row CT Colonography: A Systematic Approach RadioGraphics, March 1, 2007; 27(2): 431 - 454. [Abstract] [Full Text] [PDF]

				P. J. Pickhardt, A. J. Taylor, D. H. Kim, M. Reichelderfer, D. V. Gopal, and P. R. Pfau Screening for Colorectal Neoplasia with CT Colonography: Initial Experience from the 1st Year of Coverage by Third-Party Payers Radiology, November 1, 2006; 241(2): 417 - 425. [Abstract] [Full Text] [PDF]