Document Detail

CT colonography: positioning order and intracolonic pressure.
MedLine Citation:
PMID:  18806149     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The purpose of this study was to prospectively evaluate the effect of the order of positions on sustained rectal pressure and factors affecting pain perceived by patients during air-insufflated CT colonography. SUBJECTS AND METHODS: Rectal pressure was measured in the supine and prone positions for CT colonography of 379 patients in two groups. One hundred seventy-seven patients underwent imaging supine and then prone, and 202 patients were prone and then supine. Insufflation and patient pain parameters were based on patient self-report and investigator visualization of observable indicators. Colonic distention, residual feces or fluid, and diverticulosis were evaluated with a semiquantitative scoring system. Fisher's exact, Student's t, and chi-square tests as well as multivariate logistic regression analysis were performed. RESULTS: Pressure was higher in the prone than in the supine position in both groups (p < 0.001). The measured pressure in the initial position did not differ between groups (p = 0.88). Pressure increased from 38.3 to 40.07 mm Hg in the second position in the supine-first group and decreased from 38.3 to 32.25 mm Hg in the second position in the prone-first group (p < 0.001). The percentage of patients with pain in the second position was 40% in the supine-first group compared with 18% in the prone-first group (p < 0.003). Distention did not differ between the groups. Pain was associated with increased pressure and diverticulosis (p < 0.001) but not with retained feces or fluid. CONCLUSION: Sustained pressure in the air-insufflated colon was higher in the prone than in the supine position. Imaging in the prone position first results in a significant decrease in pressure in the latter phase and less pain. Pain was associated with pressure and diverticulosis.
Jacob Sosna; Jacob Bar-Ziv; Eugene Libson; Merab Eligulashvili; Arye Blachar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  191     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-22     Completed Date:  2008-10-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1100     Citation Subset:  AIM; IM    
Department of Radiology, Hadassah-Hebrew University Medical Center, Ein Kerem POB 12000, Jerusalem, Israel 91120.
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MeSH Terms
Abdominal Pain / radiography
Aged, 80 and over
Chi-Square Distribution
Colon / physiology
Colonography, Computed Tomographic / methods*
Imaging, Three-Dimensional
Insufflation / methods
Logistic Models
Middle Aged
Prone Position / physiology*
Prospective Studies
Rectum / physiology
Supine Position / physiology*

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