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Open Access 03-03-2022 | Crohn's Disease | Gastrointestinal

Influence of oral contrast type and volume on patient experience and quality of luminal distension at MR Enterography in Crohn’s disease: an observational study of patients recruited to the METRIC trial

Authors: Gauraang Bhatnagar, Sue Mallett, Laura Quinn, Rajapandian Ilangovan, Uday Patel, Asif Jaffer, Christopher Pawley, Arun Gupta, Anthony Higginson, Andrew Slater, Damian Tolan, Ian Zealley, Steve Halligan, Stuart A Taylor, on behalf of the METRIC study investigators

Published in: European Radiology | Issue 8/2022

Abstract

Objectives

To compare the distention quality and patient experience of oral mannitol and polyethylene glycol (PEG) for MRE.

Methods

This study is a retrospective, observational study of a subset of patients enrolled in a multicentre, prospective trial evaluating the diagnostic accuracy of MRE for small bowel Crohn’s. Overall and segmental MRE small bowel distention, from 105 patients (64 F, mean age 37) was scored from 0 = poor to 4 = excellent by two experienced observers (68 [65%] mannitol and 37 [35%] PEG). Additionally, 130 patients (77 F, mean age 34) completed a questionnaire rating tolerability of various symptoms immediately and 2 days after MRE (85 [65%] receiving mannitol 45 [35%] receiving PEG). Distension was compared between agents and between those ingesting ≤ 1 L or > 1 L of mannitol using the test of proportions. Tolerability grades were collapsed into “very tolerable,” “moderately tolerable,” and “not tolerable.”

Results

Per patient distension quality was similar between agents (“excellent” or “good” in 54% [37/68] versus 46% [17/37]) with mannitol and PEG respectively. Jejunal distension was significantly better with mannitol compared to PEG (40% [27/68] versus 14% [5/37] rated as excellent or good respectively). There was no significant difference according to the volume of mannitol ingested. Symptom tolerability was comparable between agents, although fullness following MRE was graded as “very tolerable” in 27% (12/45) of patients ingesting PEG, verses 44% (37/84) ingesting mannitol, difference 17% (95% CI 0.6 to 34%).

Conclusion

Mannitol-based solutions and PEG generally achieve comparable distension quality and side effect profiles, although jejunal distension is better quality with mannitol. Neither distension quality nor side-effect profile is altered by ingestion of more than 1 L of mannitol.

Key Points

• Mannitol-based and PEG-based oral preparation agents generally achieve comparable distension quality for MRE with the exception of the jejunum which is better distended with mannitol.

• Mannitol-based and PEG-based oral preparation agents used for MRE have similar side effect profiles.

• Neither distension quality nor side-effect profile is altered by ingestion of more than 1 L of mannitol.

Available only for authorised users

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Title: Influence of oral contrast type and volume on patient experience and quality of luminal distension at MR Enterography in Crohn’s disease: an observational study of patients recruited to the METRIC trial
Authors: Gauraang Bhatnagar
Sue Mallett
Laura Quinn
Rajapandian Ilangovan
Uday Patel
Asif Jaffer
Christopher Pawley
Arun Gupta
Anthony Higginson
Andrew Slater
Damian Tolan
Ian Zealley
Steve Halligan
Stuart A Taylor
on behalf of the METRIC study investigators
Publication date: 03-03-2022
Publisher: Springer Berlin Heidelberg
Keywords: Crohn's Disease
Mannitol
Published in: European Radiology / Issue 8/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-022-08614-9

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Influence of oral contrast type and volume on patient experience and quality of luminal distension at MR Enterography in Crohn’s disease: an observational study of patients recruited to the METRIC trial

Abstract

Objectives

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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