Upper gastrointestinal tract and abdomen: Water as an orally administered contrast agent for helical CT

PURPOSE: To evaluate the use of orally administered water as a negative contrast agent and intravenously administered glucagon in helical computed tomography (CT) of the upper abdomen. MATERIALS AND METHODS: Ninety-eight adult patients underwent 102 helical CT examinations. Patients received 700 mt of water orally 30 minutes before and another 350 mt of water orally with 1 mg of glucagon intravenously just before CT. The amount of water actually ingested was recorded. Luminal distention at five sites was graded on a three-point scale; depiction of six normal anatomic structures was evaluated. RESULTS: Luminal distention improved with the amount of water ingested in four of the five sites (P < .03 in three sites). Depiction of all six normal anatomic structures improved with increasing luminal distention (P < .001). The normal duodenal papilla was seen in 42% (83 of 198) of the examinations. Of 87 patients who had previously undergone CT with positive oral contrast agents, 89% (n = 77) preferred the water, 11% (n = 10) had no preference, and none preferred the positive agent (P < .001). Upper gastrointestinal tract abnormalities were easily recognized and depicted. CONCLUSION: Water is an efficacious negative contrast agent for evaluation of the upper gastrointestinal tract during helical CT.