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Comparison of Water, Mannitol and Positive Oral Contrast for Evaluation of Bowel by Computed Tomography |
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Padhmanaban Elamparidhi, Selvakkalanjiyam Sivaranjanie,
Rudrappa Ramesh Kumar, Rajkumar Sibhithran, A. Amaresh Kumar 1. Senior Resident, Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India. 2. Postgraduate, Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India. 3. Head, Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India. 4. Postgraduate, Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India. 5. Postgraduate, Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India. |
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Correspondence Address : Dr. Selvakkalanjiyam Sivaranjanie, 6/335 Vaikkalpatri, Salem-636005, Tamil Nadu, India. E-mail: kssiva12@gmail.com |
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| ABSTRACT |  | ||||||||||||||||||||||||||||||||||||
: Morphometry of body and neural arch of lumbar vertebrae is very crucial in manufacturing screws, interspinous implants as well as preoperative planning of surgeries involving dorsolumbar spine. Aim: To determine various dimensions of typical and atypical lumbar vertebrae. Materials and Methods: A descriptive osteological study was carried out which included 66 intact adult dry human lumbar vertebrae (53 typical and 13 atypical) which were free of any deformity or pathological features. All the 53 typical vertebrae were randomly obtained. The following parameters were measured with slide callipers- superior transverse diameter and superior antero-posterior diameters of vertebral foramen; transverse diameter, antero-posterior diameter and anterior height of vertebral body; width, height of pedicles; interpedicular distance; maximum thickness of lamina; length of transverse process; maximum length, maximum height and maximum central thickness of spinous process. The data was tabulated and analysed using Microsoft Excel software. Mean and standard deviation was calculated for each parameter. Unpaired t-test was applied and p-value was derived for parameters like width and height of pedicles, thickness of lamina and length of transverse process. The p-value<0.05 were considered as significant. Results: The vertebral foramen (superior transverse diameter- 20.41±2.54 mm, superior antero-posterior diameter- 13.3±2.04 mm); vertebral body (transverse diameter- 44.43±5.91 mm, antero-posterior diameter- 30.17±3.19 mm, anterior height- 24.01±1.84 mm); pedicle (width- 10.85±3.94 mm on left side and 11.04±4.01 mm on right side, height- 13.84±4.01 mm on left side and 13.8±1.93 mm on right side, interpedicular distance- 29.17±5.06 mm); lamina (thickness- 6.6±1.36 mm on left side and 6.85±1.34 mm on right side); transverse process (length- 20.94±4.01 mm on left side and 21.51±4.5 mm on right side); spinous process (maximum length- 26.01±3.73 mm, maximum height- 19.92±4.03 mm, maximum central thickness- 6.42±1.41 mm). The mean transverse diameter and antero-posterior diameter of vertebral foramen of atypical lumbar vertebrae were higher than those of the typical lumbar vertebrae and these differences were significant (p-value of 0.0001 for transverse diameter and p-value of 0.005 for antero-posterior diameter). Conclusion: Most of the parameters of atypical lumbar vertebrae were found to be more compared to those of typical lumbar vertebrae. This inference should be kept in mind during fixation of lumbar inter-spinous implants, designing of pedicular screws and spinal grafting. | |||||||||||||||||||||||||||||||||||||
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| Keywords : Bowel distention, Endoluminal contrast, Mural fold visibility | |||||||||||||||||||||||||||||||||||||
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| INTRODUCTION |
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Imaging of the bowel has been a challenge to the radiologists. Each imaging modality has its own merits and demerits. The small bowel is always a challenging area for surgeon and gastroenterologist because of its long length and patients with bowel pathology present with vague symptoms. Barium investigation is less sensitive (1),(2). Capsule endoscopy gives a lot of information about bowel but visualization of the outer wall of bowel is not possible and if there is bowel stenosis, capsule gets retained. Ultrasound has an advantage of real time imaging without ionizing radiation and is less expensive and easily available. But it is less sensitive for bowel pathologies especially small bowel because of the scatter of ultrasound beam by air within the bowel. CT with its good spatial and contrast resolution along with its multiplanar reconstruction provides a good platform for the evaluation of bowel. It also has the advantage of evaluation of mesentery which plays an important role in narrowing down differentials. Bowel distension is an important prerequisite in CT evaluation of bowel to open up the collapsed loops which might obscure the underlying pathology (2),(3). Contrast enhanced abdominal scan with oral contrast helps us to evaluate the bowel adequately. In this study we have compared water, 3% mannitol and diluted gastrograffin for assessing intraluminal distention, mucosal fold visualization and mural enhancement. | |||||||||||||||||||||||||||||||||||||
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| TABLES AND FIGURES |
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Original article / research
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