Abdominal Helical CT: Milk as a Low-Attenuation Oral Contrast Agent

Abstract

One hundred ten consecutive patients were given either whole (4%) milk, 2% milk, water, barium suspension, or no oral contrast agent before abdominal computed tomography (CT). Results with whole milk were superior to those with all other agents for gastrointestinal distention, mural visualization, and pancreas-duodenum discrimination. In bowel loop discrimination, results with 4% milk were equal to those with barium but superior to those with all other agents. Whole (4%) milk is an effective low-attenuation oral contrast agent.

Milk - An Effective Low-Attenuation Computed Tomography Oral Contrast Medium

“…20 Various low-attenuation oral contrast agents have been explored for use with abdominal CT. 21 Among these agents, whole milk has been shown to compare favorably with traditional positive oral contrast material in gastrointestinal tract distention and mural visualization. 5,12 Our study focused on comparing the two agents with respect to effectiveness in bowel distention and mural visualization, patient acceptance, and cost.…”

“…[5][6][7][8][9][10][11] Although air had been advocated as an alternative to high-attenuation oral contrast material for gastric and large-bowel imaging 12 , the production of artifacts and the requirement of wide window settings for viewing render it a suboptimal agent for soft-tissue contrast resolution. 13 Taking advantage of the inherent contrast between water attenuation and contrast material-enhanced bowel wall, Winter et al 6 used water as an oral contrast agent, resulting in excellent luminal and mucosal depiction of the upper gastrointestinal tract.…”

“…In addition, gastrointestinal tract distention and small-bowel discrimination were comparable to those in studies using a barium suspension and superior to imaging performed with water. 5 More recently, a newly developed low-attenuation 0.1% barium suspension (Volumen, E-Z-EM Inc.) has been shown to provide excellent gastrointestinal tract distention and superb visualization of mural features compared with barium suspension and a methylcellulose-water mixture. 12 We hypothesize that milk will be well tolerated, more cost-effective, better than iopamiro for mural visualization with similar degrees of gastrointestinal tract distention and discrimination as iopamiro.…”

Small intestinal tumors: diagnostic accuracy of enhanced multi-detector CT virtual endoscopy

“…Isotonic mannitol may remain in the bowel for longer, but it may cause diarrhea [13]. Pure milk [14,15] and vegetable oil emulsion are not well-tolerated by patients, so their clinical applications are limited.…”

Malignant tumours of the small intestine: a review of histopathology, multidetector CT and MRI aspects

“…Highly concentrated barium or iodine solutions must be avoided because too high an intraluminal attenuation can jeopardise the identification of small hypervascular masses (i.e. carcinoid tumours) or compromise the evaluation of mesenteric vessels [13,14]. The use of peristalsis inhibitors such hyoscine N-butyl bromide (HBB, Buscopan Boehringer Ingelheim GmbH, Ingelheim am Rhein, Germany) is strongly recommended (intravenous administration after completing intestinal preparation) in order to prolong lumen distension and avoid movement artefacts.…”