Lostumbo Antonella, Suzuki Kenji, Dachman Abraham H
Department of Radiology, MC 2026, University of Chicago Hospitals, 5841 S. Maryland Ave., Chicago, IL 60637, USA.
Abdom Imaging. 2010 Oct;35(5):578-83. doi: 10.1007/s00261-009-9562-3. Epub 2009 Jul 25.
Flat lesions have been a source of controversy because of concerns that CT colonography (CTC) is insensitive in detecting these lesions, yet they may harbor a high incidence of advanced neoplasia. The wide variation in the reported incidence of flat lesions may in part be due to the lack of a uniform definition of "flat", and in fact in many prior reports the inclusion criteria for flat are not even clearly specified. Emphasis on the more recent CTC literature suggests that when limited the target lesion to neoplasia (adenomas or adenocarcinoma), the incidence of flat lesions is low and most can be detected by CTC. Using fecal tagging and careful attention to the proper methods of searching for flat lesions with both 3D and 2D techniques can maximize the detection of flat lesions at CTC. Computer-aided detection may be helpful.
扁平病变一直是争议的源头，因为有人担心CT结肠成像（CTC）在检测这些病变时不敏感，但它们可能具有较高的进展期肿瘤发生率。所报道的扁平病变发生率差异很大，部分原因可能是缺乏对“扁平”的统一界定，事实上在许多先前的报告中，扁平病变的纳入标准甚至都未明确规定。对最新的CTC文献的研究表明，当将目标病变限定为肿瘤（腺瘤或腺癌）时，扁平病变的发生率较低，且大多数可通过CTC检测到。使用粪便标记并在三维和二维技术中都仔细关注寻找扁平病变的正确方法，可最大限度地提高CTC对扁平病变的检测率。计算机辅助检测可能会有所帮助。
