Ginnerup Pedersen B, Christiansen T E M, Bjerregaard N C, Ljungmann K, Laurberg S
Department of Radiology, Aarhus Amtssygehus, Aarhus University Hospital, Tage Hansensgade 2, 8000 Aarhus C, Denmark.
Endoscopy. 2003 Sep;35(9):736-42. doi: 10.1055/s-2003-41584.
Computed-tomographic (CT) colonography has been introduced as a minimally invasive colon examination for the detection of colorectal neoplasms. The aim of this study was to compare the performance characteristics of multidetector-array CT colonography (MDCTC) and conventional colonoscopy in a prospective, blinded design.
Sixty-six symptomatic patients, 75 patients undergoing polyp and cancer surveillance, and seven patients undergoing preoperative colonoscopy due to colorectal cancer (CRC) were examined with MDCTC and subsequent colonoscopy. The gold standard was colonoscopy. If MDCTC was positive and the first-pass colonoscopy was negative, a second-pass colonoscopy served as the gold standard.
Complete colonoscopy was achieved in 91% of the patients, while technically satisfying MDCTC was obtained in 76% of the patients (P < 0.01), insufficient air distension in the sigmoid colon being the main problem. MDCTC and colonoscopy both detected all 11 carcinomas. Overall detection rates for polypoid lesions 6 mm or larger in size were 81% (95% CI, 70% to 90%) for MDCTC and 87% (95% CI, 77% to 94%) for colonoscopy (P = 0.52), with a significant difference with regard to the detection of polyps 6-9 mm in size in favor of colonoscopy (P = 0.008). The specificity of MDCTC at a 6-mm level was 97% (95% CI, 92% to 99%).
MDCTC and colonoscopy show equal overall sensitivity for the detection of polypoid lesions 6 mm or larger in size, but more patients are inadequately examined when MDCTC is used.
计算机断层扫描（CT）结肠成像已作为一种用于检测结直肠肿瘤的微创性结肠检查方法被引入。本研究的目的是以前瞻性、盲法设计比较多排螺旋CT结肠成像（MDCTC）和传统结肠镜检查的性能特征。
对66例有症状的患者、75例接受息肉和癌症监测的患者以及7例因结直肠癌（CRC）接受术前结肠镜检查的患者进行了MDCTC及随后的结肠镜检查。金标准为结肠镜检查。如果MDCTC呈阳性而初次结肠镜检查为阴性，则第二次结肠镜检查作为金标准。
91%的患者完成了全结肠镜检查，而76%的患者获得了技术上满意的MDCTC检查结果（P<0.01），乙状结肠充气不足是主要问题。MDCTC和结肠镜检查均检测出了所有ll例癌。MDCTC对大小为6mm或更大的息肉样病变的总体检出率为81%（95%CI，70%至90%），结肠镜检查为87%（95%CI，77%至94%）（P=0.52），在检测6 - 9mm大小的息肉方面，结肠镜检查有显著优势（P = 0.008）。MDCTC在6mm水平的特异性为97%（95%CI，92%至99%）。
MDCTC和结肠镜检查对大小为及更大的息肉样病变的总体敏感性相同，但使用MDCTC时未得到充分检查的患者更多。
