Magnetic Resonance Colonography Without Bowel Cleansing Using Oral And Rectal Stool Softeners (Fecal Cracking)--A Feasibility Study

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Journal Title, Volume, Page: 
Eur Radiol (2005) 15: 2079–2087
Year of Publication: 
2005
Authors: 
Waleed Ajaj
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital of Essen, Hufelandstrasse 55, 45122, Essen, Germany
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Thomas C. Lauenstein
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital of Essen, Hufelandstrasse 55, 45122, Essen, Germany
Hubert Schneemann
Institute of Pharmacy & Pharmaceutical Sciences, University Hospital of Essen, Essen, Germany
Christiane Kuehle
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital of Essen, Hufelandstrasse 55, 45122, Essen, Germany
Christoph U. Herborn
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital of Essen, Hufelandstrasse 55, 45122 Essen, Germany
Susanne C. Goehde
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital of Essen, Hufelandstrasse 55, 45122, Essen, Germany
Stefan G. Ruehm
Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
Mathias Goyen
Medical Center, University Hospital of Hamburg-Eppendorf, Hamburg, Germany
Preferred Abstract (Original): 

The aim of our study was to assess the effect of oral and rectal stool softeners on dark-lumen magnetic resonance (MR) colonography without bowel cleansing. Ten volunteers underwent MR colonography without colonic cleansing. A baseline examination was performed without oral or rectal administration of stool softeners. In a second set, volunteers ingested 60 ml of lactulose 24 h prior to MR examination. In a third examination, water as a rectal enema was replaced by a solution of 0.5%-docusate sodium (DS). A fourth MR examination was performed, in conjunction with both oral administration of lactulose and rectal application of DS. A T1-weighted data set was acquired at scanning times of 0, 5 and 10 min after colonic filling. A fourth data set was acquired 75 s after i.v. injection of contrast agent. Signal intensity of stool was calculated for all colonic segments. Without oral ingestion of lactulose or rectal enema with DS stool signal intensity was high and did not decrease over time. However, lactulose and DS caused a decrease in stool signal intensity. Both substances together led to a decreasing signal intensity of feces. Combination of lactulose and DS provided the lowest signal intensity of stool. Thus, feces could hardly be distinguished from dark rectal enema allowing for the assessment of the colonic wall.

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