Department of Radiology, Clínica Universidad de Navarra, Av. Pio XII, 36, 31008, Pamplona, Navarra, Spain.
Hospital Reina Sofía de Tudela, Carr. de Tarazona, Km. 3, 31500, Tudela, Navarra, Spain.
Radiol Med. 2019 Dec;124(12):1199-1211. doi: 10.1007/s11547-019-01068-y. Epub 2019 Aug 12.
There is a growing awareness that prevention and early diagnosis may reduce the high mortality associated with cancer, cardiovascular and other diseases. The role of whole-body computed tomography (WB-CT) in self-referred and asymptomatic patients has been debated.
To determine frequency and spectrum of WB-CT findings in average-risk subjects derived from a Medical-Check-Up-Unit, to evaluate recommendations reported and distribution according to sex and age-groups.
We retrospectively reviewed 6516 subjects who underwent WB-CT (June 2004/February 2015). All were > 40 years and referred by Medical-Check-Up-Unit of our hospital. The main findings were categorized and classified as normal or not. Its distribution according to sex and age-groups was evaluated using Chi-square test and linear-by-linear association test, respectively. Number of recommendations, type and interval of follow-up were recorded. Descriptive statistics were used.
WB-CT performed in 6516 patients (69% men, 31% women, mean age = 58.4 years) revealed chest (81.4%), abdominal (93.06%) and spine (65.39%) abnormalities. Only 1.60% had completely normal exploration. Abnormal WB-CT in men was significantly higher than women (98.64% vs. 97.87%; p = 0.021), with significant increase as age was higher (40-49 years: 95.65%; 50-59 years: 98.33%; 60-69 years: 99.47%; > 69 years: 99.89%) (p < 0.001). Although most findings were benign, we detected 1.47% primary tumors (96, mainly 35 kidneys and 15 lungs). 17.39% of patients received at least one recommendation predominantly in chest (78.19%) and follow-up imaging (69.89%).
The most common WB-CT findings in asymptomatic subjects are benign. However, this examination allows identifying an important number of relevant and precocious findings that significantly increase with age, involving changes in lifestyle and precocious treatment.
人们越来越意识到，预防和早期诊断可能会降低与癌症、心血管疾病和其他疾病相关的高死亡率。全身计算机断层扫描（WB-CT）在自我转诊和无症状患者中的作用一直存在争议。
确定从医疗检查单位获得的平均风险患者的 WB-CT 检查结果的频率和范围，评估报告的建议并按性别和年龄组进行分布。
我们回顾性分析了 6516 名接受 WB-CT 检查的患者（2004 年 6 月至 2015 年 2 月）。所有患者均>40 岁，由我院医疗检查单位转诊。主要发现分为正常和异常两类。使用卡方检验和线性线性关联检验分别评估其性别和年龄组的分布。记录建议的数量、类型和随访间隔。使用描述性统计进行分析。
对 6516 例患者（69%为男性，31%为女性，平均年龄 58.4 岁）进行了 WB-CT 检查，结果显示胸部（81.4%）、腹部（93.06%）和脊柱（65.39%）异常。只有 1.60%的患者完全正常。男性异常 WB-CT 明显高于女性（98.64%比 97.87%；p=0.021），且随年龄升高而显著增加（40-49 岁：95.65%；50-59 岁：98.33%；60-69 岁：99.47%；>69 岁：99.89%）（p<0.001）。尽管大多数发现是良性的，但我们检测到 1.47%的原发性肿瘤（96 例，主要为 35 例肾脏和 15 例肺部）。17.39%的患者至少接受了一项建议，主要集中在胸部（78.19%）和随访影像学检查（69.89%）。
无症状患者中最常见的 WB-CT 发现是良性的。然而，这项检查可以发现大量重要的相关且早期的发现，这些发现随着年龄的增长而显著增加，涉及生活方式的改变和早期治疗。
