Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
Dig Liver Dis. 2013 Aug;45(8):645-50. doi: 10.1016/j.dld.2013.02.020. Epub 2013 May 2.
To retrospectively study the frequency and magnitude of complications associated with computed tomography (CT) colonography in clinical practice.
A questionnaire on complications of CT colonography was sent to Italian public radiology departments identified as practicing CT colonography with a reasonable level of training. The frequency of complications and possible risk factors were retrospectively determined. Responses were collated and row frequencies determined. A multivariate analysis of the factors causing adverse events was also performed.
40,121 examinations were performed in13 centers during the study period. No deaths were reported. Bowel perforations occurred in 0.02% (7 exams). All perforations were asymptomatic and occurred in patients undergoing manual insufflation. Five perforations (71%) occurred in procedures performed following a recent colonoscopy. There was no significant difference between perforations associated with rectal balloon (0.017%) and those that were not (0.02%). Complications related to vasovagal reaction (either with or without spasmolytic) occurred in 0.16% (63 exams). All vasovagal reactions resolved in less than 3h, without any sequelae.
Perforation rate at CT colonography in Italy is comparable with elsewhere in the world, occurring regardless of the experience of radiology centers. Although the risk is very small, it may not be negligible when compared with the risk of diagnostic colonoscopy.
回顾性研究计算机断层扫描(CT)结肠成像在临床实践中相关并发症的发生频率和严重程度。
向意大利公共放射科部门发送了一份关于 CT 结肠成像并发症的调查问卷,这些部门被确定为具有合理培训水平的 CT 结肠成像实践单位。回顾性确定并发症的发生频率和可能的危险因素。对引起不良事件的因素进行了多变量分析。
在研究期间,13 个中心共进行了 40121 次检查。未报告死亡。肠穿孔发生率为 0.02%(7 例)。所有穿孔均为无症状,发生于手动注气的患者中。5 例穿孔(71%)发生于最近行结肠镜检查后。直肠气囊相关穿孔(0.017%)与非直肠气囊相关穿孔(0.02%)之间无显著差异。与血管迷走神经反应(无论是否使用解痉剂)相关的并发症发生率为 0.16%(63 例)。所有血管迷走神经反应均在 3 小时内缓解,无任何后遗症。
意大利 CT 结肠成像的穿孔率与世界其他地区相当,无论放射科中心的经验如何,均可能发生穿孔。尽管风险很小,但与诊断性结肠镜检查的风险相比,可能不容忽视。