Comparison of Two Neutral Oral Contrast Agents in Pediatric Patients: A Prospective Randomized Study.
Radiology. 2018 Jul;288(1):245-251. doi: 10.1148/radiol.2018173039. Epub 2018 May 8. Dillman JR1, Towbin AJ1, Imbus R1, Young J1, Gates E1, Trout AT1.
Purpose: To prospectively compare small bowel distention provided by, as well as patient acceptance of, two different neutral (negative) oral contrast materials used for cross-sectional enterography in a pediatric population.
Materials and Methods: In this noninferiority study, 66 pediatric patients undergoing clinical computed tomographic (CT) or magnetic resonance (MR) enterography were randomized to receive either a flavored beverage for neutral abdominal and pelvic imaging (Breeza; Beekley Medical, Bristol, Conn) or a low-density barium sulfate suspension. Patients were blinded to the oral contrast material administered and were asked to rate taste, texture, and their perceived health state (where 0 was very bad and 10 was very good). Ingested volume of the prescribed weight-based oral contrast material preparation was recorded. Maximum small bowel diameter was measured in all four abdominal quadrants. Mean bowel diameter as well as taste, texture, and health state scores were compared between cohorts by using t tests; proportions were compared by using Fisher exact tests.
Results: Thirty-three patients each received Breeza and barium sulfate suspension, respectively. No difference was found in age (Breeza, 13.5 years ± 2.6 [standard deviation]; barium sulfate suspension, 13.9 years ± 2.8; P = .49), sex distribution (15 girls each; P > .99), or health state (P = .21) between cohorts. Twenty-eight of 33 (84.8%) and 17 of 33 (51.5%) patients completed the Breeza and barium sulfate suspension preparations, respectively (P = .007). Breeza received higher scores for taste (6.1 ± 2.5 vs 2.7 ± 2.5; P < .0001) and texture (7.3 ± 2.3 vs 3.6 ± 2.9; P < .0001). No difference was found in bowel distention between Breeza and barium sulfate suspension (1.63 cm ± 0.24 vs 1.69 cm ± 0.25; P = .44).
Conclusion: The neutral oral contrast materials Breeza and low-density barium sulfate suspension provide similar small bowel distention. Patients receiving Breeza are more likely to ingest the entire prescribed volume.