Department of Radiology, Bordesley Green East, Heart of England NHS Foundation Trust, Birmingham, UK.
Eur Radiol. 2011 Oct;21(10):2029-38. doi: 10.1007/s00330-011-2151-1. Epub 2011 May 22.
CT Colonography (CTC) is being increasingly used for the radiological evaluation of colorectal symptoms. Aim of this study was to assess the role of CTC in excluding a colorectal cancer (CRC) in older symptomatic patients.
1,359 CTC studies performed between March 2002 and December 2007 were analysed retrospectively. Gold standard was an endoscopic examination within 1 year and/or clinical, endoscopic and/or radiological follow-up until the time of data analysis. Patients not diagnosed as having a CRC on CTC were assumed as true-negatives if the gold standard was negative and did not feature on the regional cancer registry (at least 18 months post-CTC). Sensitivity, specificity, positive and negative predictive values were calculated for detection of colorectal cancer.
After exclusions, 1,177 CTC studies were included. These were undertaken in 463 men and 714 women. Median age of patients undergoing CTC was 71 (range, 27-96) years. 59 invasive CRC were detected. Median follow-up was 34.5 (range 18-84) months. Three small colorectal cancers were missed. Sensitivity and negative predictive value for CRC were 94.9% (95% CI:84.9%-98.7%) and 99.7% (95% CI:99.1%-99.9%) respectively.
CTC has a high sensitivity and negative predictive value in excluding a CRC in patients with colorectal symptoms.
CT 结肠成像（CTC）越来越多地用于结直肠症状的放射学评估。本研究的目的是评估 CTC 在排除老年有症状患者结直肠癌（CRC）中的作用。
回顾性分析 2002 年 3 月至 2007 年 12 月间进行的 1359 例 CTC 研究。金标准为 1 年内的内镜检查和/或临床、内镜和/或放射学随访，直至数据分析时间。如果 CTC 未诊断为 CRC 且金标准为阴性且未在区域癌症登记处（CTC 后至少 18 个月）登记，则假定为真阴性。计算了 CTC 检测结直肠癌的敏感性、特异性、阳性预测值和阴性预测值。
排除后，共纳入 1177 例 CTC 研究。这些研究纳入了 463 名男性和 714 名女性。接受 CTC 检查的患者中位年龄为 71 岁（范围 27-96 岁）。发现 59 例侵袭性 CRC。中位随访时间为 34.5 个月（范围 18-84 个月）。漏诊了 3 例小的结直肠癌。CRC 的敏感性和阴性预测值分别为 94.9%（95%CI：84.9%-98.7%）和 99.7%（95%CI：99.1%-99.9%）。
CTC 在排除有结直肠症状的患者的 CRC 方面具有较高的敏感性和阴性预测值。
