Comparison of two barium suspensions for dedicated small-bowel series

OBJECTIVE. The in vivo radiographic features of two commercially available formulations of barium used as contrast media in dedicated small-bowel seri es were compared. SUBJECTS AND METHODS. Fifty-six consecutive outpatients referred for a dedi cated small-bowel series were randomly administered either E-Z-Paque or Ent robar. Representative survey radiographs from each examination were randomi zed and reviewed by six gastrointestinal radiologists from three institutio ns. Each observer assigned a numeric score (1 = poor, 2 = fair, 3 = good, a nd 4 = excellent) that rated the quality of the radiograph with respect to these characteristics: definition of fold pattern, translucency, distention , and integrity of the barium column. Statistical analysis was performed fo r each characteristic using Wilcoxon's two-sample rank sum test. RESULTS. All six observers found a statistically significant difference bet ween the two barium formulations for mean scores for definition of fold pat tern and translucency. Mean scores for fold pattern were 3.3, 3.0, 3.2, 3.6 , 3.3, and 3.4 for Entrobar and 2.1, 2.3, 2.4, 3.2, 2.6, and 2.7 for E-Z-Pa que. Mean scores for translucency were 2.5, 2.7, 2.8, 3.1, 2.7, and 3.3 for Entrobar and 1.6, 1.7, 2.1, 2.3, 1.9. and 2.7 for E-Z-Paque. No statistica lly significant difference was found for mean score for distention or integ rity of the barium column. CONCLUSION. On radiographs, Entrobar was found to have superior characteris tics for visualization of fold pattern and translucency but offered no adva ntages for distention or integrity of the barium column. Improved transluce ncy and definition of fold pattern may translate into improved sensitivity and confidence in diagnosing small-bowel abnormality.