SYSTEMATIC REVIEW: MANNITOL AS ENTERIC CONTRAST MEDIUM IN CONTRAST-ENHANCED CT ABDOMEN
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Keywords
Mannitol, Enteric Contrast Medium, CT Enterography
Abstract
Oral contrast agents are essential for optimal bowel distension and mucosal visualization during contrast-enhanced computed tomography (CECT) of the abdomen. Mannitol, a hyperosmotic neutral agent, has been proposed as an effective alternative to conventional agents like water, polyethylene glycol (PEG), and iodinated contrast.
Objectives:
This systematic review aims to evaluate the efficacy, safety, patient tolerability, and diagnostic performance of mannitol as an enteric contrast medium in CECT abdomen compared to other oral contrast agents.
Methods:
A systematic literature search was conducted of PubMed, Scopus, and Google Scholar databases for studies published in the last five years assessing mannitol for oral contrast in abdominal CT. Studies with quantitative or qualitative data on bowel distension, image quality, adverse effects, and patient compliance were included. Data were synthesized narratively due to heterogeneity in study designs and protocols.
Results:
Multiple studies encompassing adult patients undergoing CT enterography or colonography showed that mannitol at 3% concentration (1,500–2,000 mL) administered 30–60 minutes pre-scan provided superior bowel distension and mucosal visualization compared to water and iodinated contrast. Mannitol resulted in fewer imaging artifacts and enhanced diagnostic confidence. The safety profile was favorable, with mild, transient side effects including bloating, nausea, and diarrhea. Patient compliance and palatability were higher with mannitol than PEG-based agents. However, study limitations included small sample sizes and heterogenous methodology.
Conclusions:
Mannitol is an effective, safe, and well-tolerated oral contrast medium for CECT abdomen, offering superior bowel distension, minimal image artifacts, and improved patient acceptance. It is recommended for routine use in CT enterography and colonography. Further large-scale randomized studies are needed to optimize protocols and confirm efficacy.
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Dr. Jatla Jyothi Swaroop
Mbbs, Md Radiodiagnosis Assistant Professor, Department Of Radiodiagnosis, Nimra Institute Of Medical Sciences (Nims), Ibrahimpatnam, Vijaywada, Andhra Pradesh, 521456