Martín-López J E, Carlos-Gil A M, Luque-Romero L, Flores-Moreno S
Agencia de Evaluación de Tecnologías Sanitarias, Sevilla, España.
Radiologia. 2011 Jul-Aug;53(4):355-63. doi: 10.1016/j.rx.2010.11.003. Epub 2011 Feb 26.
To determine the efficacy and effectiveness of CT colonography in comparison with those of colonoscopy in screening for colorectal cancer.
We systematically reviewed all the studies in the scientific literature that assessed the efficacy of CT colonography in screening for colorectal cancer. We excluded articles that assessed the efficacy of other screening techniques for colorectal cancer and those that used CT colonography in the diagnostic workup of suspected lesions or symptomatic patients. After a critical reading of the 213 references obtained, we selected nine studies.
The specificity of CT colonography in screening for colorectal cancer was high, although it decreased with the diameter of the polyp to be detected. The sensitivity of CT colonography in the detection of polyps less than or equal to 6mm in diameter was very low and heterogeneous, although it was higher for polyps greater than 9mm in diameter.
CT colonography has high specificity but very heterogeneous sensitivity, although in most cases it was not as sensitive or specific as conventional colonoscopy.
确定CT结肠成像与结肠镜检查在结直肠癌筛查中的有效性和效能。
我们系统回顾了科学文献中所有评估CT结肠成像在结直肠癌筛查中效能的研究。我们排除了评估其他结直肠癌筛查技术效能的文章,以及在疑似病变或有症状患者的诊断检查中使用CT结肠成像的文章。在仔细阅读获取的213篇参考文献后,我们选择了9项研究。
CT结肠成像在结直肠癌筛查中的特异性较高,不过会随着待检测息肉的直径减小而降低。CT结肠成像对直径小于或等于6mm息肉的检测灵敏度非常低且存在异质性,而对直径大于9mm的息肉检测灵敏度更高。
CT结肠成像具有较高的特异性,但灵敏度存在很大异质性,尽管在大多数情况下其灵敏度和特异性不如传统结肠镜检查。