Yee Judy, Kumar Naveen N, Hung Raymond K, Akerkar Geetanjali A, Kumar Prasanna R G, Wall Susan D
Department of Radiology (114), Veterans Affairs Medical Center, 4150 Clement St, San Francisco, CA 94121, USA.
Radiology. 2003 Mar;226(3):653-61. doi: 10.1148/radiol.2263010701. Epub 2003 Jan 15.
To compare colonic distention, adequacy of colonic preparation, and colorectal polyp detection as assessed with supine and prone scanning separately and in combination at computed tomographic (CT) colonography.
CT colonography and colonoscopy were performed in 182 patients. Distention and preparation of eight colonic segments were rated separately on a scale of 1-4 (1, segment completely distended or no residual material; 4, segment collapsed or large amounts of residual material). The distention, preparation, and polyp detection data were compared with regard to each position alone and then in combination. CT findings were correlated with colonoscopic findings.
The percentage of colonic segments with grade 1 distention and preparation was 93.7% (1,364 of 1,456) and 66.6% (969 of 1,456), respectively, with combined scanning; 86.4% (1,258 of 1,456) and 52.1% (759 of 1,456), respectively, with supine scanning alone; and 85.6% (1,246 of 1,456) and 57.1% (831 of 1,456), respectively, with prone scanning alone. The sensitivity for detection of colorectal polyps 10 mm or larger, 5.0-9.9 mm, and smaller than 5 mm and polyps of all sizes was 92.7%, 79.8%, 60.3%, and 69.9%, respectively, with combined scanning. Sensitivity was 58.5%, 47.2%, 36.3%, and 42.1%, respectively, with supine scanning and 51.2%, 41.6%, 30.2%, and 36.3%, respectively, with prone scanning. The improved sensitivities for use of combined versus individual scanning positions were highly significant (P <.001) for polyps in all size categories.
Colonic distention and preparation at CT colonography were significantly improved by using supine and prone scanning in combination, and results correlated directly with improved sensitivity of polyp detection.
比较在计算机断层扫描（CT）结肠成像中，分别采用仰卧位和俯卧位扫描以及联合使用这两种扫描方式时结肠扩张情况、结肠准备的充分程度和结直肠息肉的检出情况。
对182例患者进行了CT结肠成像和结肠镜检查。八个结肠段的扩张和准备情况分别按照1 - 4级进行评分（1级表示结肠段完全扩张或无残留物质；4级表示结肠段塌陷或有大量残留物质）。分别比较了每种扫描位置单独使用以及联合使用时的扩张、准备和息肉检出数据。CT检查结果与结肠镜检查结果进行了相关性分析。
联合扫描时，扩张和准备情况为1级的结肠段百分比分别为93.7%（1456个中的1364个）和66.6%（1456个中的969个）；仅仰卧位扫描时分别为86.4%（1456个中的1258个）和52.1%（1456个中的759个）；仅俯卧位扫描时分别为85.6%（1456个中的1246个）和57.1%（1456个中的831个）。联合扫描时，对直径10 mm及以上、5.0 - 9.9 mm、小于5 mm的结直肠息肉以及所有大小息肉的检出敏感性分别为92.7%、79.8%、60.3%和69.9%。仰卧位扫描时敏感性分别为58.5%、47.2%、36.3%和42.1%，俯卧位扫描时敏感性分别为51.2%、41.6%、30.2%和36.3%。联合扫描与单独使用扫描位置相比，对所有大小类别的息肉，敏感性提高均非常显著（P <.001）。
在CT结肠成像中，联合使用仰卧位和俯卧位扫描可显著改善结肠扩张和准备情况，且结果与息肉检出敏感性的提高直接相关。
