Szenes Mária, Nagy Gyöngyi, Gyömbér Edit, Girán Bettina, Fischer Tünde, Völgyi Zoltán, Gasztonyi Beáta
Zala Megyei Kórház, Belgyógyászat, Zalaegerszeg.
Orv Hetil. 2008 Jun 22;149(25):1161-5. doi: 10.1556/OH.2008.28210.
Colonoscopy is a golden standard in the diagnostics of intraluminal diseases of the large intestine. Its advantage is the possibility of histological sampling (biopsy) and therapeutical interventions. In case of technical difficulties (stenosis, severe inflammation, diverticulosis, anatomical alterations) or lack of informed consent of the patient double contrast colonography is the routine diagnostic tool for the examination of the entire large intestine. The spread of the use of colon capsule as a novelty is keeping us waiting. A very important criteria is the adjudication of the expansion of the intestinal disease to the surrounding and distant organs. The correct diagnostics are the base of therapy planning. CT colonography as a standardizable imaging method can give information at once about the intraluminal aberrations, the spread to the surroundings and the abdominal status. The rapid, minimal invasive technology without sedation using multidetector CTs makes the method widely applicable.
The authors search for the locus of CT colonography in the diagnostics of non-malignant diseases of the large intestine, in the screening of colorectal carcinoma and during tumor staging.
Data of 92 males (mean age: 61.2+/-12.3 years) and 146 females (mean age 61.4+/-12.5 years) were collected after CT colonography had been performed at Zala County Hospital between September 2002 and January 2007. Indications, protocols and results determining further business have been reviewed.
The reason of CT colonography was the failure of colonoscopy in 29% of the 238 patients. In 45/238 patients (19%) stricture of the colon, in 23/238 cases (10%) pain, lack of compliance and technical difficulties were the reasons of failure. In 60% of the remaining 23 persons organic intestinal diseases were diagnosed. In 151 cases (63%) the lack of informed consent for colonoscopy was the reason of radiological examinations, pathological aberrations were found in every second patient. Aiming to learn the method, CT colonography was performed after total colonoscopy in 19/238 patients after informed consent.
CT colonography is a useful tool in the algorithm of diagnostics of colorectal diseases in the case of lack of performing total colonoscopy.
结肠镜检查是大肠腔内疾病诊断的金标准。其优势在于能够进行组织学取样（活检）和治疗干预。在存在技术困难（狭窄、严重炎症、憩室病、解剖结构改变）或患者未签署知情同意书的情况下，双重对比结肠造影是检查整个大肠的常规诊断工具。结肠胶囊作为一种新技术的应用推广尚有待时日。一个非常重要的标准是判定肠道疾病向周围及远处器官的扩散情况。正确的诊断是治疗规划的基础。CT结肠造影作为一种可标准化的成像方法，能够立即提供有关腔内异常、向周围组织的扩散情况以及腹部状况的信息。使用多排探测器CT的快速、微创技术且无需镇静，使得该方法具有广泛的适用性。
作者探寻CT结肠造影在大肠非恶性疾病诊断、结直肠癌筛查及肿瘤分期中的地位。
收集了2002年9月至2007年1月在扎拉县医院进行CT结肠造影后的92例男性患者（平均年龄：61.2±12.3岁）和146例女性患者（平均年龄61.4±12.5岁）的数据。对决定后续诊疗的指征、方案及结果进行了回顾。
在238例患者中，29%进行CT结肠造影的原因是结肠镜检查失败。在45/238例患者（19%）中，结肠狭窄，在23/238例患者（10%）中，疼痛、患者不配合及技术困难是失败原因。在其余23例患者中的60%诊断出器质性肠道疾病。在151例患者（63%）中，未签署结肠镜检查知情同意书是进行放射学检查的原因，每两名患者中就有一名发现病理异常。为学习该方法，在19/238例患者签署知情同意书后，在全结肠镜检查后进行了CT结肠造影。
在无法进行全结肠镜检查的情况下，CT结肠造影是结直肠疾病诊断流程中的一种有用工具。
