Bowel Preparation for Imaging Studies: Systematic Review

Abstract

The authors performed a systematic review to summarize data on the approaches and methods of bowels preparation for radiography, radiology and ultrasound studies. The review included 15 articles on computed tomography (CT) and 30 articles on magnetic resonance imaging (MRI). Due to the limited evidence, researches on X-ray and ultrasound (US) studies are not included in the review; the authors just summarized the main provisions for these modalities. The bowels preparation must be completed before making the CT colonography (diet, bowel cleansing within max. 24 hours, marking the residual content). For purification, solutions of low-volume polyethylene glycol (PEG) 2 L with ascorbate complex and electrolytes, bisacodyl and other medications were used. The choice of a specific drug regimen of bowels cleansing should be based on a personalized approach to patient, balance, consideration of studies purpose and reasons. The bowels preparation must be completed before making the MRI (two ways: complete cleansing (most often with low-volume polyethylene glycol 2 L solutions with ascorbate complex and electrolytes or diet, followed by contrasting the residual content). There is no reliable information on the benefits of each particular approach. The insufficient evidence is due to the lack of comparative studies. When performing the MRI of men's small pelvic, doctors use antispasmodics, for women they prefer diet, mechanical cleansing, suppositories with bisacodyl or magnesia, followed by rehydration on the day of studies. There is currently no reliable data on the need in bowels preparation before making the following studies: CT of abdominal cavity and small pelvis (except for the large intestine), excretory urography, metro(hystero)salpingography, ultrasound of the large intestine. PEG solutions with electrolytes have relative advantages in preparing bowels for radiation studies (possibility of using in cases when the prescription of other laxatives is contraindicated).

Keywords

• radiology
• bowels preparation
• virtual colonoscopy
• computed tomography
• radiography
• magnetic resonance imaging
• polyethylene glycol
• macrogol