Gryspeerdt Stefaan S, Herman Murielle J, Baekelandt Marc A, van Holsbeeck Bartel G, Lefere Philippe A
Department of Radiology, Stedelijk Ziekenhuis, Bruggesteenweg 90, 8800 Roeselare, Belgium.
Eur Radiol. 2004 May;14(5):768-77. doi: 10.1007/s00330-004-2264-x. Epub 2004 Feb 19.
The purpose was to evaluate supine/left decubitus as an alternative to supine/prone scanning in computed tomographic colonography (CT colonography). Fifty patients were randomised to supine/prone, another 50 to supine/left decubitus scanning. Patients were scanned using a single-slice CT scanner. The colon was divided into eight segments. Comparisons of distension, breathing artefacts, residus and polyp detection were made between the two groups as well as between the different positions. Adequate distension was found in approximately 85, 97 and 95% of segments in the supine, prone and left decubitus positions, respectively. Combined scanning increased the percentage of adequate distension to 98.5% for prone-supine and 97.7% for left decubitus-supine scanning ( P<0.0005 compared to supine, P=0.001 compared to left decubitus and P=0.046 compared to prone scanning). Absence of residual material was found in approximately 62.7, 69.7 and 64% of segments in the supine, prone and left decubitus positions, respectively. Combined scanning increased this percentage to approximately 99% for both groups. No significant differences towards distension or residual material were found between combined supine-prone or supine-left decubitus scanning. In the supine-prone group, combined scanning additionally revealed four lesions and improved conspicuity in two cases of stalked polyps. In the supine-left decubitus group, combined scanning additionally revealed two lesions and improved conspicuity in one stalked polyp. There were significantly fewer breathing artefacts with left decubitus scanning than prone scanning ( P=0.005). A strong positive correlation was found between breathing artefacts and the age of patients in both patient groups. Colonic distension and preparation is improved by using supine and prone or supine and left decubitus scanning in combination, with a subsequent improved polyp detection. There were no significant differences between the two scanning protocols. Prone scanning, however, is hampered by breathing artefacts, especially in the elderly. Therefore, supine-left decubitus scanning is considered a valuable alternative to supine-prone scanning for the elderly.
本研究旨在评估在计算机断层结肠成像（CT结肠成像）中，仰卧位/左侧卧位扫描能否替代仰卧位/俯卧位扫描。将50例患者随机分为仰卧位/俯卧位组，另外50例分为仰卧位/左侧卧位组进行扫描。使用单层CT扫描仪对患者进行扫描。将结肠分为8个节段。比较两组之间以及不同体位之间的扩张情况、呼吸伪影、残留物质和息肉检测情况。仰卧位、俯卧位和左侧卧位节段中分别约85%、97%和95%实现了充分扩张。联合扫描使俯卧位-仰卧位扫描的充分扩张百分比提高到98.5%，左侧卧位-仰卧位扫描提高到97.7%（与仰卧位相比，P<0.0005；与左侧卧位相比，P=0.001；与俯卧位扫描相比，P=0.046）。仰卧位、俯卧位和左侧卧位节段中分别约62.7%、69.7%和64%未发现残留物质。联合扫描使两组的这一百分比均提高到约99%。仰卧位-俯卧位联合扫描与仰卧位-左侧卧位联合扫描在扩张或残留物质方面未发现显著差异。在仰卧位-俯卧位组中，联合扫描还发现了4个病变，并改善了2例有蒂息肉的显示效果。在仰卧位-左侧卧位组中，联合扫描还发现了2个病变，并改善了1例有蒂息肉的显示效果。左侧卧位扫描的呼吸伪影明显少于俯卧位扫描（P=0.005）。在两个患者组中，呼吸伪影与患者年龄之间均发现了强正相关。联合使用仰卧位和俯卧位或仰卧位和左侧卧位扫描可改善结肠扩张和准备情况，并随后提高息肉检测率。两种扫描方案之间没有显著差异。然而，俯卧位扫描受到呼吸伪影的影响较大，尤其是在老年人中。因此，对于老年人来说仰卧位-左侧卧位扫描被认为是仰卧位-俯卧位扫描的一个有价值的替代方案。
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