Iannaccone Riccardo, Laghi Andrea, Catalano Carlo, Mangiapane Filippo, Piacentini Francesca, Passariello Roberto
Department of Radiology, University of Rome La Sapienza, Policlinico Umberto I, Viale Regina Elena, 324, 00161 Rome, Italy.
Eur Radiol. 2003 Jun;13(6):1297-302. doi: 10.1007/s00330-002-1704-8. Epub 2002 Sep 21.
Our objective was to evaluate the feasibility of ultra-low-dose scanning for multislice CT colonography in the detection of colorectal lesions. Twenty-seven patients (14 men, 13 women) with clinical indication for conventional colonoscopy were recruited. Multislice spiral CT (Somatom Plus 4 Volume Zoom, Siemens, Germany) examinations were performed after standard oral colonoscopic preparation and colonic distension with room air. Images were acquired using 2.5-mm collimation, 3.0-mm slice thickness, standard reconstruction kernel, 140 kVp, and 10 mAs. Supine and prone acquisitions were obtained in all patients. Images were analyzed on a workstation by two gastrointestinal radiologists. Conventional colonoscopy was performed on the same day in all patients and represented the standard of reference. Total radiation exposure was also calculated. All colorectal cancers were correctly identified at CT colonography (9 of 9, sensitivity 100%). The CT colonography also detected 10 of 12 polyps (overall sensitivity 83.3%). Based on polyp diameter, the sensitivity for the detection of polyps 10 mm or larger was 100% (3 of 3); between 6 and 9 mm, 100% (3 of 3); and 5 mm or smaller, 66.6% (4 of 6). Total radiation exposure for prone and supine acquisitions combined was 1.7 mSv (for men) and 2.3 mSv (for women). Although preliminary, our experience suggests that ultra-low-dose scanning for multislice CT colonography is feasible. This technique provides a sensitivity comparable to that of previous experiences with CT colonography but with a 40-70% reduction of the radiation dose delivered to patients.
我们的目的是评估多层螺旋CT结肠成像超低剂量扫描在检测结直肠病变中的可行性。招募了27例有传统结肠镜检查临床指征的患者（14例男性，13例女性）。在进行标准的口服结肠镜检查准备并使用室内空气使结肠扩张后，进行多层螺旋CT（德国西门子Somatom Plus 4 Volume Zoom）检查。图像采集采用2.5毫米准直、3.0毫米层厚、标准重建核、140千伏峰值电压和10毫安秒。所有患者均进行仰卧位和俯卧位采集。两名胃肠放射科医生在工作站上对图像进行分析。所有患者均在同一天进行传统结肠镜检查，作为参考标准。还计算了总的辐射暴露量。在CT结肠成像中所有结直肠癌均被正确识别（9例中的9例，敏感性100%）。CT结肠成像还检测出12例息肉中的10例（总体敏感性83.3%）。根据息肉直径，检测10毫米或更大息肉的敏感性为100%（3例中的3例）；6至9毫米的息肉，敏感性为100%（3例中的3例）；5毫米或更小的息肉，敏感性为66.6%（6例中的4例）。仰卧位和俯卧位采集的总辐射暴露量男性为1.7毫希沃特，女性为2.3毫希沃特。尽管是初步的，但我们的经验表明多层螺旋CT结肠成像超低剂量扫描是可行的。该技术提供的敏感性与之前CT结肠成像的经验相当，但可使患者所接受的辐射剂量降低40%至70%。
