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当日行 CT 结肠成像检查在结肠镜检查不完全时的质量。

Quality of same-day CT colonography following incomplete optical colonoscopy.

机构信息

Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, 02114, USA.

Department of Radiology, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.

出版信息

Eur Radiol. 2020 Dec;30(12):6508-6516. doi: 10.1007/s00330-020-06979-3. Epub 2020 Jul 1.

Abstract

OBJECTIVES

Same-day CT colonography (CTC) following incomplete optical colonoscopy allows patients to avoid both a delayed diagnosis and the need for repeat bowel preparation. The aim of our study is to establish the diagnostic quality of same-day CT colonography following an incomplete optical colonoscopy.

METHODS

We performed a retrospective review of patients undergoing same-day CT colonography following an incomplete colonoscopy at our center between July 2015 and December 2017 (N = 245). We divided the large bowel into thirteen subsegments in each patient. Using a semiquantitative scoring system, the quality of bowel preparation, adequacy of fecal tagging, and luminal distension were assessed in each subsegment on all views performed. A combined score for each subsection was obtained.

RESULTS

Ninety-nine percent of studies did not require a repeat CTC or optical colonoscopy. Median values for bowel preparation and fecal tagging were satisfactory across the bowel segments for the cohort and luminal distension was acceptable in all but three patients.

CONCLUSIONS

Same-day CTC should be considered in centers with capacity, following an incomplete optical colonoscopy. Same-day completion CTCs are of high diagnostic quality and this approach allows patients to avoid repeat bowel cleansing or a delayed diagnosis.

KEY POINTS

• Same-day CT colonography is a high-quality examination that can be performed following incomplete optical colonoscopy. • Same-day CT colonography should be considered for patients with incomplete optical colonoscopy in centers with the capacity to offer this service. • Same-day CTC can avoid a delay in diagnosis and avoids repeat bowel preparation.

摘要

目的

在光学结肠镜检查不完全的情况下进行当日 CT 结肠成像(CTC)可以使患者避免延迟诊断和重复肠道准备。我们的研究目的是确定在不完全光学结肠镜检查后进行当日 CT 结肠成像的诊断质量。

方法

我们对 2015 年 7 月至 2017 年 12 月期间在我们中心接受当日 CT 结肠成像检查的不完全结肠镜检查患者(N=245)进行了回顾性研究。我们将大肠在每个患者中分为 13 个亚段。使用半定量评分系统,在所有进行的视图上评估每个亚段的肠道准备质量、粪便标记程度和肠腔扩张情况。获得每个子部分的综合评分。

结果

99%的研究不需要重复进行 CTC 或光学结肠镜检查。对于该队列,肠道准备和粪便标记的中位数值在整个肠道段都令人满意,除了三名患者外,所有患者的肠腔扩张都可以接受。

结论

在有能力的中心,在光学结肠镜检查不完全的情况下,应考虑进行当日 CTC。当日完成的 CTC 具有较高的诊断质量,这种方法可以避免患者重复肠道清洁或延迟诊断。

关键点

  • 当日 CT 结肠成像检查是一种高质量的检查方法,可在不完全光学结肠镜检查后进行。

  • 在有能力提供此服务的中心,对于不完全光学结肠镜检查的患者,应考虑进行当日 CT 结肠成像检查。

  • 当日 CTC 可避免诊断延迟并避免重复肠道准备。

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