采用超低剂量技术的多层螺旋CT结肠成像检测大肠息肉：与高分辨率电子结肠镜检查的比较

Detection of colorectal polyps by multislice CT colonography with ultra-low-dose technique: comparison with high-resolution videocolonoscopy.

作者信息

Vogt Christoph, Cohnen Mathias, Beck Andreas, vom Dahl Stephan, Aurich Volker, Mödder Ulrich, Häussinger Dieter

机构信息

Division of Medicine, Department of Gastroenterology, Hepatology and Infectious Diseases, Institute of Diagnostic Radiology, Heinrich-Heine-University of Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, Germany.

出版信息

Gastrointest Endosc. 2004 Aug;60(2):201-9. doi: 10.1016/s0016-5107(04)01684-0.

DOI:10.1016/s0016-5107(04)01684-0

PMID:15278045

Abstract

BACKGROUND

This prospective study compared multislice CT colonography with ultra-low-dose technique to high-resolution videocolonoscopy as the standard for detection of colorectal cancer and polyps.

METHODS

After standard bowel preparation, 115 patients underwent multislice CT colonography with an ultra-low-dose multislice CT colonography protocol immediately before videocolonoscopy. After noise reduction by using a mathematical algorithm, ultra-low-dose multislice CT colonographic images were analyzed in blinded fashion, and the results were compared with the results of high-resolution videocolonoscopy.

RESULTS

A total of 150 lesions were detected by high-resolution videocolonoscopy in 115 patients. For ultra-low-dose multislice CT colonography, sensitivities for detection of polyps less than 5 mm in size, 5 to 10 mm, and greater than 10 mm in diameter were 76%, 91%, and 100%, respectively. Although the sensitivity for detection of flat lesions was only 50%, the sensitivity and the specificity for detection of polyps 5 mm or greater in size were 94% and 84%, respectively. For adenomatous lesions greater than 5 mm in size, sensitivity was 94% and specificity was 92%. The overall specificity was 79%. The calculated effective radiation dose ranged between 0.75 and 1.25 mSv.

CONCLUSIONS

Compared with high-resolution videocolonoscopy, ultra-low-dose multislice CT colonography has excellent sensitivity and specificity for detection of colorectal lesions 5 mm or greater in size, and the radiation exposure is relatively low. However, before this technique can be generally recommended for colorectal screening, further improvement in the detection of flat and extremely small lesions must be achieved.

摘要

背景

本前瞻性研究将采用超低剂量技术的多层螺旋CT结肠成像与作为检测结直肠癌和息肉标准的高分辨率电子结肠镜检查进行比较。

方法

在进行标准肠道准备后，115例患者在电子结肠镜检查前立即接受采用超低剂量多层螺旋CT结肠成像方案的多层螺旋CT结肠成像检查。使用数学算法进行降噪后，以盲法分析超低剂量多层螺旋CT结肠成像图像，并将结果与高分辨率电子结肠镜检查结果进行比较。

结果

115例患者通过高分辨率电子结肠镜检查共检测到150个病变。对于超低剂量多层螺旋CT结肠成像，检测直径小于5mm、5至10mm以及大于10mm息肉的敏感度分别为76%、91%和100%。尽管检测扁平病变的敏感度仅为50%，但检测直径5mm或更大息肉的敏感度和特异度分别为94%和84%。对于直径大于5mm的腺瘤性病变，敏感度为94%，特异度为92%。总体特异度为79%。计算得出的有效辐射剂量在0.75至1.25mSv之间。