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计算机断层结肠成像的三维重建揭示了与结肠镜检查失败相关的解剖学特征。

Three-dimensional reconstruction of computed tomography colonography discloses anatomic features associated with colonoscopy failure.

作者信息

Hochstein David, Tejman-Yarden Shai, Saukhat Olga, Vazgovski Oliana, Parmet Yisrael, Nagar Netanel, Ram Edward, Carter Dan

机构信息

St. Goerge's University of London, London, UK.

Engineering Medical Laboratory, The Edmond J. Safra International Congenital Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel.

出版信息

Therap Adv Gastroenterol. 2023 Mar 21;16:17562848231160625. doi: 10.1177/17562848231160625. eCollection 2023.

DOI:10.1177/17562848231160625
PMID:36968619
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10031618/
Abstract

OBJECTIVES

Three-dimensional virtual reality (3D VR) permits precise reconstruction of computed tomography (CT) images, and these allow precise measurements of colonic anatomical parameters. Colonoscopy proves challenging in a subset of patients, and thus CT colonoscopy (CTC) is often required to visualize the entire colon. The aim of the study was to determine whether 3D reconstructions of the colon could help identify and quantify the key anatomical features leading to colonoscopy failure.

DESIGN

Retrospective observational study.

METHODS

Using 3D VR technology, we reconstructed and compared the length of various colonic segments and number of bends and colonic width in 10 cases of CTC in technically failed prior colonoscopies to 10 cases of CTC performed for non-technically failure indications.

RESULTS

We found significant elongation of the sigmoid colon (71 ± 23 cm 35 ± 9;  = 0.01) and of pancolonic length (216 ± 38 cm 158 ± 20 cm;  = 0.001) in cases of technically failed colonoscopy. There was also a significant increase in the number of colonic angles (17.7 ± 3.2 12.7 ± 2.4;  = 0.008) in failed colonoscopy cases.

CONCLUSION

Increased sigmoid and pancolonic length and more colonic bends are novel factors associated with technical failure of colonoscopy.

摘要

目的

三维虚拟现实（3D VR）技术可对计算机断层扫描（CT）图像进行精确重建，进而能够精确测量结肠解剖参数。在一部分患者中，结肠镜检查具有挑战性，因此通常需要进行CT结肠成像（CTC）来观察整个结肠。本研究的目的是确定结肠的三维重建是否有助于识别和量化导致结肠镜检查失败的关键解剖特征。

设计

回顾性观察研究。

方法

利用3D VR技术，我们对10例先前结肠镜检查技术失败的CTC病例和10例因非技术失败指征而进行的CTC病例的各结肠段长度、弯曲数量和结肠宽度进行了重建和比较。

结果

我们发现，在结肠镜检查技术失败的病例中，乙状结肠显著延长（71±23厘米对35±9厘米；P = 0.01），全结肠长度也显著延长（216±38厘米对158±20厘米；P = 0.001）。在结肠镜检查失败的病例中，结肠角的数量也显著增加（17.7±3.2对12.7±2.4；P = 0.008）。

结论

乙状结肠和全结肠长度增加以及结肠弯曲增多是与结肠镜检查技术失败相关的新因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9da/10031618/f2d6b1c39ae9/10.1177_17562848231160625-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9da/10031618/fa5248b52e29/10.1177_17562848231160625-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9da/10031618/f2d6b1c39ae9/10.1177_17562848231160625-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9da/10031618/fa5248b52e29/10.1177_17562848231160625-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9da/10031618/f2d6b1c39ae9/10.1177_17562848231160625-fig2.jpg

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