Hartmann D, Bassler B, Pfeifer B, Eickhoff A, Weickert U, Riemann J F, Layer G
Medizinische Klinik C, Klinikum der Stadt Ludwigshafen gGmbH, Brenserstrasse 79, 67063 Ludwigshafen am Rhein.
Dtsch Med Wochenschr. 2006 Nov 10;131(45):2519-23. doi: 10.1055/s-2006-955043.
Precondition for establishment of magnetic resonance colonography (MRCG) as a diagnostic tool in secondary prevention of colorectal cancer is not only high diagnostic accuracy but also a good acceptance amongst patients. The aim of this study was to compare post-examination appraisal of patients for MRCG to that of bowel preparation and conventional colonoscopy.
88 patients (24 women, 64 men, mean age 67 +- 17,3 years) were interviewed by a standardized questionnaire regarding pain/discomfort (scale from 1 to 10), overall assessment of difficulties and preference for future tests. After bowel cleansing, MRCG and conventional colonoscopy were performed on the same day. Bowel cleansing consisted of drinking about 5 liters of a polyethylene glycol-electrolyte solution. For MRCG the colon was filled with ca. 2000 ml of tap water. Imaging was performed with a 1.5T MR scanner in the prone position.
Most unpleasant for the patients was the preceding bowel preparation (70%), followed by colonoscopy (14%) and MRCG (8%). The preferred method was MRCG (58%) followed by colonoscopy (20,5%). The most unpleasant symptoms named by patients were the amount of oral electrolyte solution that had to be drunk (34%), abdominal pressure (25%), nausea (24%) because of bowel preparation, body positioning (25%) and rectal tube (13%) during MRCG, abdominal pressure (19%) and pain (18%) during colonoscopy.
Patients' acceptance of MRCG indicates that it has a potential role as an additional diagnostic tool in secondary prevention of colorectal cancer.
磁共振结肠成像(MRCG)要成为结直肠癌二级预防中的诊断工具,前提条件不仅是要有高诊断准确性,还要能被患者良好接受。本研究的目的是比较患者对MRCG检查后的评价与肠道准备及传统结肠镜检查的评价。
采用标准化问卷对88例患者(24例女性,64例男性,平均年龄67±17.3岁)进行访谈,询问疼痛/不适情况(1至10分)、对检查难度的总体评价以及对未来检查的偏好。肠道清洁后,于同一天进行MRCG和传统结肠镜检查。肠道清洁采用饮用约5升聚乙二醇电解质溶液的方法。MRCG检查时,向结肠内注入约2000毫升自来水。使用1.5T磁共振扫描仪在俯卧位进行成像。
对患者来说最不舒服的是之前的肠道准备(70%),其次是结肠镜检查(14%)和MRCG(8%)。首选方法是MRCG(58%),其次是结肠镜检查(20.5%)。患者提到的最不舒服的症状是肠道准备时必须饮用的口服电解质溶液量(34%)、腹部压力(25%)、恶心(24%)、MRCG检查时的体位(25%)和直肠管(13%)、结肠镜检查时的腹部压力(19%)和疼痛(18%)。
患者对MRCG的接受度表明,它在结直肠癌二级预防中作为一种额外的诊断工具具有潜在作用。