Brisling Steffen, Adamsen Sven, Nørgaard Henrik, Brink Lene, Hermann Kirstine Lintrup, Arnesen Regnar Bøge
Herlev Hospital, Gastroenheden, Kirurgisk Sektion D-113, Herlev.
Ugeskr Laeger. 2008 Apr 28;170(18):1563-6.
CT-colonography (CTC) is recommended in the case of an incomplete conventional colonoscopy (CC). The present study was initiated to assess feasibility and outcomes in same-day CTC after incomplete CC.
Out of 480 consecutive patients who had CC for symptoms or for surveillance, 50 were incomplete for reasons other than insufficient preparation. If possible, CTC was performed on the same day in dual positions without contrast. Where CTC found suspected polyps, patients had a re-CC for verification and removal, and subsequent surgery in the case of cancer.
Reasons for incomplete CC were loop formation (24%), pain (48%), kinking or external compression (24%) or benign strictures (4%). 43 of 50 CTCs (86%, 95% CI 73-94%) were conclusive. The organization allowed for 25 patients (50%) to have CTC on the same day. CTC detected 17 suspected polyps/masses, 13 of which were verified in 12 patients (28%). Re-CC or surgery verified 3 out of 4 of the suspected polyps < or = 5 mm, 5 out of 6 of those sized 6-9 mm, and 5 out of 7 of the masses > 9 mm (including 2 cancers). 19 (38%) had previously undetected extra-intestinal disease, including metastases in 4 patients, a uterine cancer in one, and a 7 cm abdominal aortic aneurism in one.
Same-day CTC after incomplete CC is feasible and effective.
对于不完全常规结肠镜检查（CC）的情况，推荐进行CT结肠成像（CTC）。本研究旨在评估不完全CC后同日进行CTC的可行性和结果。
在480例因症状或监测而接受CC的连续患者中，50例因准备不充分以外的原因检查不完全。若可能，同日在不使用对比剂的情况下进行双体位CTC检查。若CTC发现疑似息肉，患者需再次进行CC以进行核实和切除，若为癌症则随后进行手术。
不完全CC的原因包括肠袢形成（24%）、疼痛（48%）、扭结或外部压迫（24%）或良性狭窄（4%）。50例CTC中有43例（86%，95%可信区间73 - 94%）结果明确。机构安排使25例患者（50%）能够同日进行CTC检查。CTC检测到17个疑似息肉/肿物，其中13个在12例患者中得到核实（28%）。再次CC或手术核实了4个直径≤5mm的疑似息肉中的3个、6 - 9mm大小的6个中的5个以及＞9mm的肿物中的7个中的5个（包括2例癌症）。19例（38%）患者此前未被发现有肠外疾病，包括4例转移、1例子宫癌和1例7cm腹主动脉瘤。
不完全CC后同日进行CTC是可行且有效的。
