Buchach Christopher M, Kim David H, Pickhardt Perry J
Department of Radiology, University of Wisconsin School of Medicine and Public Health, Clinical Science Center, Madison, 53792-3252, USA.
Abdom Imaging. 2011 Oct;36(5):538-44. doi: 10.1007/s00261-010-9666-9.
To determine the rate and associated factors for acquiring a decubitus series at CT colonography (CTC), in addition to the standard supine and prone series.
CTC examinations read centrally at one institution but performed at three different centers in 6,380 adults were reviewed to determine the frequency of an additional decubitus series. Results were analyzed according to study indication (primary screening vs. diagnostic for incomplete colonoscopy), practice site (academic vs. community), patient age, gender, body mass index (BMI), and temporal variation. At all sites, the CT technologist determined the need for an additional decubitus series, with infrequent radiologist input in select cases.
The frequency for the CT technologist to obtain a decubitus series at screening was 9.7% (578/5,952), compared with 22.9% (98/428) following failed colonoscopy (P < 0.001). The decubitus rate for screening at the academic center (9.4%, 550/5,871) was significantly lower than the community hospitals (34.6% combined, 28/81) (P < 0.001). The rate progressively increased with age, from 5.0% under age 50 to 28.0% over age 80. No significant difference was seen between men and women (10.3 vs. 9.2%), but a strong correlation existed with increased BMI, rising to >25% for BMI over 40. Marked temporal variation existed at the academic center, with quarterly rates ranging from 0 to 17%.
The frequency for performing a third series at CTC varies considerably according to indication, practice site, patient age, BMI, and time. These results have important implications for clinical practice, including the need for improved training and feedback for CT technologists.
除标准仰卧位和俯卧位系列外，确定在CT结肠成像（CTC）时获取卧位系列的比率及相关因素。
回顾了在一个机构集中阅片但在三个不同中心对6380名成年人进行的CTC检查，以确定额外卧位系列的频率。根据研究指征（初次筛查与结肠镜检查不完全的诊断）、执业地点（学术机构与社区）、患者年龄、性别、体重指数（BMI）和时间变化对结果进行分析。在所有地点，CT技师确定是否需要额外的卧位系列，在某些情况下放射科医生参与较少。
CT技师在筛查时获取卧位系列的频率为9.7%（578/5952），而结肠镜检查失败后为22.9%（98/428）（P<0.001）。学术中心筛查时的卧位比率（9.4%，550/5871）显著低于社区医院（合并为34.6%，28/81）（P<0.001）。该比率随年龄逐渐增加，从50岁以下的5.0%增至80岁以上的28.0%。男性和女性之间无显著差异（10.3%对9.2%），但与BMI增加呈强相关，BMI超过40时升至>25%。学术中心存在明显的时间变化，季度比率范围为0至17%。
在CTC时进行第三个系列检查的频率根据指征、执业地点、患者年龄、BMI和时间有很大差异。这些结果对临床实践具有重要意义，包括需要改进对CT技师的培训和反馈。
