Centre for Medical Imaging, University College London, London, UK.
Br J Radiol. 2013 Jun;86(1026):20130137. doi: 10.1259/bjr.20130137. Epub 2013 Apr 8.
This paper argues for the use of CT colonography (CTC) to investigate patients with symptoms potentially suggestive of colorectal cancer. It describes the rationale for the UK Special Interest Group in Gastrointestinal and Abdominal Radiology (SIGGAR) randomised controlled trials that compared CTC with barium enema (BE) or colonoscopy for diagnosis of colorectal cancer or large polyps in symptomatic patients. Diagnostic outcomes from the trials are detailed for both intra- and extracolonic disease, along with psychological reactions of patients to the tests, and cost-effectiveness of the different diagnostic strategies. The author concludes that BE should be replaced by CTC immediately and that CTC is a sensitive, acceptable and equally cost-effective alternative to colonoscopy in patients in whom colonoscopy is contraindicated or undesirable.
本文主张使用 CT 结肠成像（CTC）来检查有疑似结直肠癌症状的患者。它描述了英国胃肠道和腹部放射学专业兴趣小组（SIGGAR）进行的随机对照试验的基本原理，这些试验比较了 CTC 与钡灌肠（BE）或结肠镜检查在有症状的患者中用于诊断结直肠癌或大息肉的效果。试验的诊断结果详细说明了结直肠内和结直肠外疾病，以及患者对这些检查的心理反应，以及不同诊断策略的成本效益。作者得出结论，BE 应立即被 CTC 取代，并且在结肠镜检查禁忌或不适用的患者中，CTC 是一种敏感、可接受且同样具有成本效益的结肠镜检查替代方法。
