Abstract：
OBJECTIVE: To compare MiraLAX, a hypo-osmotic lavage, and magnesium citrate (MgC), a hyper-osmotic agent for bowel preparation at CTC.
METHODS: 398 total screening CTC studies were included in this retrospective, single institution study. 297 underwent preparation with a double-dose MgC regimen (mean age, 61 ± 5.5 years; 142 male/155 female) and 101 with 8.3 oz (equivalent to 238 g PEG) of MiraLAX (mean age, 60 ± 9.6 years; 45 male/56 female). Oral contrast for tagging purposes was utilized in both regimens. Studies were retrospectively analyzed for residual fluid volume and attenuation by automated analysis, as well for subjective oral contrast coating of the normal colonic wall and polyps. 50 patients underwent successive CTC studies utilizing each agent (mean, 6.1 ± 1.7 years apart), allowing for intra-patient comparison. Chi-squared, Fisher\'s exact, McNemar, and t-tests were used for data comparison.
RESULTS: Residual fluid volume (as percentage of total colonic volume) and fluid density was 7.2 ± 4.2% and 713 ± 183 HU for the MgC cohort and 8.7 ± 3.8% and 1044 HU ± 274 for the MiraLAX cohort, respectively (p = 0.001 and p < 0.001, respectively). Similar results were observed for the intra-patient cohort. Colonic wall coating negatively influencing interpretation was noted in 1.7% of MgC vs. 6.9% of MiraLAX examinations (p = 0.008). Polyps were detected in 12% of all MgC vs. 16% of all MiraLAX CTCs (p = 0.29).
CONCLUSIONS: CTC bowel preparation with the hypo-osmotic MiraLAX agent appears to provide acceptable diagnostic quality that is comparable to the hyper-osmotic MgC agent, especially when factoring in patient safety and tolerance.
METHODS: 398 total screening CTC studies were included in this retrospective, single institution study. 297 underwent preparation with a double-dose MgC regimen (mean age, 61 ± 5.5 years; 142 male/155 female) and 101 with 8.3 oz (equivalent to 238 g PEG) of MiraLAX (mean age, 60 ± 9.6 years; 45 male/56 female). Oral contrast for tagging purposes was utilized in both regimens. Studies were retrospectively analyzed for residual fluid volume and attenuation by automated analysis, as well for subjective oral contrast coating of the normal colonic wall and polyps. 50 patients underwent successive CTC studies utilizing each agent (mean, 6.1 ± 1.7 years apart), allowing for intra-patient comparison. Chi-squared, Fisher\'s exact, McNemar, and t-tests were used for data comparison.
RESULTS: Residual fluid volume (as percentage of total colonic volume) and fluid density was 7.2 ± 4.2% and 713 ± 183 HU for the MgC cohort and 8.7 ± 3.8% and 1044 HU ± 274 for the MiraLAX cohort, respectively (p = 0.001 and p < 0.001, respectively). Similar results were observed for the intra-patient cohort. Colonic wall coating negatively influencing interpretation was noted in 1.7% of MgC vs. 6.9% of MiraLAX examinations (p = 0.008). Polyps were detected in 12% of all MgC vs. 16% of all MiraLAX CTCs (p = 0.29).
CONCLUSIONS: CTC bowel preparation with the hypo-osmotic MiraLAX agent appears to provide acceptable diagnostic quality that is comparable to the hyper-osmotic MgC agent, especially when factoring in patient safety and tolerance.
摘要：
目的：比较MiraLAX，低渗灌洗,和柠檬酸镁（MgC），CTC肠道准备的高渗透剂。
方法：本回顾性研究纳入了398项CTC筛查研究，单一机构研究。297接受了双剂量MgC方案的准备(平均年龄，61±5.5岁；142名男性/155名女性）和101名，8.3盎司（相当于238克PEG）的MiraLAX（平均年龄，60±9.6岁；男性45/女性56）。在两种方案中都使用了用于标记目的的口服对比剂。通过自动分析对研究的残余液体量和衰减进行回顾性分析，以及正常结肠壁和息肉的主观口服对比涂层。50例患者接受了使用每种药物的连续CTC研究(平均值，相距6.1±1.7年)，允许患者内部比较。卡方，费希尔的精确,McNemar,数据比较采用t检验。
结果：MgC组的残余液体量（占总结肠体积的百分比）和流体密度分别为7.2±4.2％和713±183HU，而MiraLAX组的为8.7±3.8％和1044HU±274，分别(p=0.001和p<0.001)。对于患者内组观察到类似的结果。结肠壁涂层对解释的负面影响在1.7%的MgC与MiraLAX检查的6.9%（p=0.008）。在所有MgC的12%中检测到息肉，与所有MiraLAXCTC的16%(p=0.29)。
结论：使用低渗MiraLAX剂的CTC肠道准备似乎提供了与高渗透MgC剂相当的可接受的诊断质量，特别是在考虑患者的安全性和耐受性时。
方法：本回顾性研究纳入了398项CTC筛查研究，单一机构研究。297接受了双剂量MgC方案的准备(平均年龄，61±5.5岁；142名男性/155名女性）和101名，8.3盎司（相当于238克PEG）的MiraLAX（平均年龄，60±9.6岁；男性45/女性56）。在两种方案中都使用了用于标记目的的口服对比剂。通过自动分析对研究的残余液体量和衰减进行回顾性分析，以及正常结肠壁和息肉的主观口服对比涂层。50例患者接受了使用每种药物的连续CTC研究(平均值，相距6.1±1.7年)，允许患者内部比较。卡方，费希尔的精确,McNemar,数据比较采用t检验。
结果：MgC组的残余液体量（占总结肠体积的百分比）和流体密度分别为7.2±4.2％和713±183HU，而MiraLAX组的为8.7±3.8％和1044HU±274，分别(p=0.001和p<0.001)。对于患者内组观察到类似的结果。结肠壁涂层对解释的负面影响在1.7%的MgC与MiraLAX检查的6.9%（p=0.008）。在所有MgC的12%中检测到息肉，与所有MiraLAXCTC的16%(p=0.29)。
结论：使用低渗MiraLAX剂的CTC肠道准备似乎提供了与高渗透MgC剂相当的可接受的诊断质量，特别是在考虑患者的安全性和耐受性时。
