Comparison of Pasteurized Whole Milk,
UHT Whole Milk, Water, and Diluted Iodine Contrast
as Computed Tomographic Enteric Contrasts
Piyaporn Apisarnthanarak MD*,
Tawanmai Tiangpug MD*, Sopa Pongpornsup MD*,
Sureerat Janpanich RN*, Thanyaporn Suwannasit RN*
Affiliation :
* Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To compare four computed tomographic (CT) enteric contrasts (pasteurized whole milk, UHT whole milk, water,
and diluted iodine contrast) in various aspects, including gastrointestinal (GI) distension, mural visualization, GI landmark
distinction, taste, patients’ satisfaction, adverse effects, and prices.
Material and Method: Sixty patients scheduled for whole abdominal CT at the present institution were randomized to
receive 1,000 ml of pasteurized whole milk (n = 15), UHT whole milk (n = 15), water (n = 15) and diluted iodine contrast
(n = 15) as CT enteric contrasts. Two radiologists separately assessed the GI distension (using a 4-point scale: poor, partial,
good, and full), mural visualization (using a 3-point scale: poor, partial, and good), GI landmark distinction at esophagogastric
(EG) junction, ampulla of Vater, and pancreatic head-duodenal loop (using a 3-point scale: poor, partial, and good). The
participants graded the taste of received enteric contrasts and their satisfaction using a 4-point scale (unacceptable,
unpleasant, acceptable, and pleasant). Adverse effects were evaluated by GI associated symptoms (nausea, vomiting,
abdominal cramping/discomfort, and diarrhea).
Results : Pasteurized whole milk was superior to other agents in GI distension and tended to be better than other agents in
mural visualization and GI landmark distinction. No difference in taste and patients’ satisfaction was noted between
pasteurized whole milk and other agents. Gallbladder collapse was inevitable in participants with pasteurized and UHT
whole milk consumption, due to 4% fat content in whole milk. GI adverse effects were more common in whole milk group
than other agents. The prices of pasteurized whole milk, UHT whole milk, water, and diluted iodine contrast were about
42, 40, 14, and 36 Baht, respectively.
Conclusion : Pasteurized whole milk is an attractive oral contrast agent, providing good GI distension, mural visualization,
and GI landmark discrimination. Apart from gallbladder collapse, increase of GI adverse symptoms was another major
drawback of whole milk when used as CT oral contrast, especially in Thai people.
Keywords : Pasteurized milk, UHT milk, Whole milk, Iodine contrast, CT, computed tomography
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