[断层计算机结肠成像在结直肠息肉检测中的应用价值]

[Usefulness of tomographic computer colonography for colorectal polyp detection].

作者信息

Piñol Virgínia, Pagès Mario, Castells Antoni, Bellot Pau, Carrión Josep A, Martín Marta, Caballería Joan, Ayuso M Carmen, Bordas Josep M, Piqué Josep M

机构信息

Servicio de Gastroenterología, Instituto de Enfermedades Digestivas, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.

出版信息

Med Clin (Barc). 2004 Jun 12;123(2):41-4. doi: 10.1016/s0025-7753(04)74406-1.

DOI:10.1016/s0025-7753(04)74406-1

PMID:15225481

Abstract

BACKGROUND AND OBJECTIVE

Colonoscopy is the procedure of choice for the diagnosis of colorectal neoplasms. CT colonography (CTC), a recently developed minimal invasive radiological technique, permits the identification of colorectal tumors. The aim of the present study was to evaluate the efficacy of CTC in the detection of colorectal polyps, and to establish the factors determining a diagnostic accuracy.

PATIENTS AND METHOD

Patients with colorectal polyps admitted for endoscopic polypectomy were included. CTC was performed prior to colonoscopy in all patients. Demographic and clinical data were registered, as well as the polyp characteristics. Efficacy of CTC was analyzed with respect to each individual polyp and each patient.

RESULTS

Colonoscopy identified 87 colorectal polyps in 30 patients. CTC had a sensitivity of 70% for the detection of polyps of any size, being 92%, 73% and 55% for polyps > or = 10 mm, 5-9 mm and < or = 4 mm, respectively. On the other hand, the sensitivity of CTC for the detection of pedunculated, semipedunculated and sessile polyps was 85%, 92% and 56%, respectively. Accuracy of CTC was associated with polyp size (p = 0.007) and shape (p = 0.007). Sensitivity and specificity of CTC for the identification of patients with polyps > or = 10 mm were 88% and 100%, respectively.

CONCLUSIONS

CTC is a highly accurate technique for the identification of colorectal polyps. Its diagnostic accuracy depends on lesion's size and shape.

摘要

背景与目的

结肠镜检查是诊断结直肠肿瘤的首选方法。CT结肠成像（CTC）是一种最近开发的微创放射学技术，可用于识别结直肠肿瘤。本研究的目的是评估CTC在检测结直肠息肉方面的有效性，并确定决定诊断准确性的因素。

患者与方法

纳入因内镜下息肉切除术而收治的结直肠息肉患者。所有患者在结肠镜检查前均进行了CTC检查。记录了人口统计学和临床数据以及息肉特征。针对每个息肉和每位患者分析了CTC的有效性。

结果

结肠镜检查在30例患者中发现了87个结直肠息肉。CTC检测任何大小息肉的敏感性为70%，对于直径≥10mm、5-9mm和≤4mm的息肉，敏感性分别为92%、73%和55%。另一方面，CTC检测有蒂、半有蒂和无蒂息肉的敏感性分别为85%、92%和56%。CTC的准确性与息肉大小（p = 0.007）和形状（p = 0.007）相关。CTC识别直径≥10mm息肉患者的敏感性和特异性分别为88%和100%。