Hanson Meghan E, Pickhardt Perry J, Kim David H, Pfau Patrick R
Department of Radiology, University of Wisconsin Medical School, E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI 53792-3252, USA.
AJR Am J Roentgenol. 2007 Oct;189(4):774-9. doi: 10.2214/AJR.07.2048.
Reasons for failure to reach the cecum at optical colonoscopy are multifactorial. The purpose of this study was to compare CT colonography (CTC) findings in patients with complete versus those with incomplete optical colonoscopy.
The clinical data and CTC examinations were reviewed in 100 patients who underwent CTC after incomplete optical colonoscopy. The findings were compared with a control group of 100 patients who underwent complete optical colonoscopy after CTC. The interactive 3D colon map and 2D multiplanar reconstruction images from CTC were reviewed independently by two experienced gastrointestinal radiologists for colorectal length (total, sigmoid colon, and transverse colon), number of acute angle flexures (reflecting tortuosity), and advanced diverticular disease. Discrepancies were resolved by secondary consensus review.
Significant differences existed between the complete and incomplete optical colonoscopy groups, respectively, for age (mean, 58.2 vs 63.4 years; p < 0.001), sex (60 men and 40 women vs 41 men and 59 women; p < 0.01), and prior abdominal surgery (26.0% vs 48.0%; p < 0.01). Significant differences were seen between the complete and incomplete optical colonoscopy groups, respectively, for all the CTC factors that were evaluated: total colorectal length (mean, 167.0 vs 210.8 cm; p < 0.0001), sigmoid colon length (mean, 48.7 vs 66.8 cm; p < 0.0001), transverse colon length (mean, 49.2 vs 66.3 cm; p < 0.0001), number of flexures (mean, 9.6 vs 11.9; p < 0.0001), and advanced diverticular disease (22.0% vs 34.0%; p <0.05).
Anatomic features associated with failure to reach the cecum at optical colonoscopy included colonic elongation, tortuosity, and advanced diverticular disease. These predictive factors may have implications for optical colonoscopy training and performance and for patients sent to optical colonoscopy for polyps prospectively detected at CTC.
在光学结肠镜检查中未能到达盲肠的原因是多方面的。本研究的目的是比较光学结肠镜检查完整组与不完整组患者的CT结肠成像（CTC）结果。
回顾了100例光学结肠镜检查不完整后接受CTC检查的患者的临床资料和CTC检查情况。将结果与100例在CTC检查后接受完整光学结肠镜检查的患者对照组进行比较。两名经验丰富的胃肠放射科医生独立回顾了来自CTC的交互式3D结肠地图和2D多平面重建图像，以评估结肠长度（总长、乙状结肠和横结肠）、锐角弯曲数量（反映迂曲程度）和晚期憩室病。差异通过二次共识审查解决。
光学结肠镜检查完整组与不完整组在年龄（平均58.2岁对63.4岁；p<0.001）、性别（60名男性和40名女性对41名男性和59名女性；p<0.01）和既往腹部手术史（26.0%对48.0%；p<0.01）方面分别存在显著差异。在所有评估的CTC因素方面，光学结肠镜检查完整组与不完整组之间也分别存在显著差异：结肠总长度（平均167.0厘米对210.8厘米；p<0.0001）、乙状结肠长度（平均48.7厘米对66.8厘米；p<0.0001）、横结肠长度（平均49.2厘米对66.3厘米；p<0.0001）、弯曲数量（平均9.6对11.9；p<0.0001）和晚期憩室病（22.0%对34.0%；p<0.05）。
光学结肠镜检查未能到达盲肠相关的解剖学特征包括结肠延长、迂曲和晚期憩室病。这些预测因素可能对光学结肠镜检查培训和操作以及对因在CTC检查中前瞻性检测到息肉而被送去接受光学结肠镜检查的患者有影响。
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