University of California-San Francisco/VA Medical Center, 4150 Clement Street, San Francisco, CA 94121, USA.
J Am Coll Radiol. 2010 Sep;7(9):670-8. doi: 10.1016/j.jacr.2010.05.005.
Colorectal cancer remains one of the most common causes of cancer death in this country. This malignancy is ideally suited for screening because the detection and removal of the precursor adenomatous polyp can prevent most colorectal cancers from ever forming. The choice of a test for screening involves consideration of various individual parameters, including patient age and the presence of risk factors for the development of colorectal cancer. Computed tomographic colonography (CTC) has emerged as the leading imaging technique for colorectal cancer screening in average-risk individuals on the basis of the evidence presented in this paper. The double-contrast barium enema is an alternative imaging test that is appropriate particularly when CTC is not available. In 2008, the American Cancer Society guideline for colorectal cancer screening was revised jointly with the US Multi-Society Task Force on Colorectal Cancer and the ACR to include CTC every 5 years as an option for average-risk individuals. Computed tomographic colonography is also the preferred test for colon evaluation after an incomplete colonoscopy. Imaging tests including CTC and the double-contrast barium enema are usually not indicated for colorectal cancer screening in high-risk patients with polyposis syndromes or inflammatory bowel disease. This paper presents the new colorectal cancer imaging test ratings and is the result of evidence-based consensus by the ACR Appropriateness Criteria Expert Panel on Gastrointestinal Imaging.
结直肠癌仍然是我国癌症死亡的最常见原因之一。这种恶性肿瘤非常适合进行筛查，因为检测和去除腺瘤性息肉前体可以预防大多数结直肠癌的形成。筛查测试的选择涉及到各种个体参数的考虑，包括患者年龄和结直肠癌发展的风险因素。基于本文提出的证据，计算机断层扫描结肠成像（CTC）已成为一般风险人群结直肠癌筛查的主要影像学技术。双重对比钡灌肠是一种替代的影像学检查方法，特别适用于 CTC 不可用时。2008 年，美国癌症协会与美国多学会大肠癌工作组和 ACR 联合修订了结直肠癌筛查指南，将 CTC 每 5 年作为一般风险人群的一种选择纳入其中。CTC 也是结肠镜检查不完全后的结肠评估的首选检查。对于有息肉综合征或炎症性肠病的高危患者，CTC 和双重对比钡灌肠等影像学检查通常不适用于结直肠癌筛查。本文介绍了新的结直肠癌影像学检查评级，是由 ACR 胃肠道影像学适宜性标准专家小组基于循证共识的结果。
