Chervenkov Lyubomir, Sirakov Nikolay, Georgiev Aleksander, Miteva Dimitrina, Gulinac Milena, Peshevska-Sekulovska Monika, Sekulovski Metodija, Velikova Tsvetelina
Department of Diagnostic Imaging, Medical University Plovdiv, 4000 Plovdiv, Bulgaria.
Research Complex for Translational Neuroscience, Medical University of Plovdiv, Bul. Vasil Aprilov 15A, 4002 Plovdiv, Bulgaria.
Life (Basel). 2023 Sep 13;13(9):1906. doi: 10.3390/life13091906.
(1) Although new imaging methods for examining the GIT with high diagnostic capabilities were introduced, the improvement and implementation of safe, efficient, and cost-effective approaches continue, and GIT diseases are still challenging to diagnose; (2) Methods: We aim to show the possibilities of computed tomography (CT) colonography for early diagnosis of colon diseases using a multidetector 32-channel CT scanner after appropriate preparation; (3) Results: After a colonoscopy was performed earlier, 140 patients were examined with CT colonography. Complete colonoscopy was performed in 80 patients (57.1%) out of 140 who underwent CT colonography. Incomplete colonoscopy was observed in 52 patients (37.2%); in 5 patients (3.6%), it was contraindicated, and in 3 patients (2.1%), it was not performed because of patients' refusal. We determined that in cases of complete FCS in 95% of patients, CT colonography established the same clinical diagnosis as FCS. In cases of incomplete, refused, or contraindicated FCS in 32.7% (17 patients), FCS failed to diagnose correctly. The main reasons for incomplete colonoscopy were: intraluminal obturation of tumor nature-17 patients (33%), extraluminal obturation (compression) from a tumor formation-4 patients (8%), stenotic changes of non-tumor nature-11 patients (21%), congenital diseases with changes in the length of the lumen of the intestinal loops-7 patients (13%), and subjective factors (pain, poor preparation, contraindications) in 13 patients (25%); (4) Conclusions: Our results confirmed that CT colonography is a method of choice in cases of negative FCS results accompanied by clinical data for the neoplastic process and in cases of incomplete and contraindicated FCS. Also, the insufflation system we developed optimizes the method by improving the quality of the obtained images and ensuring good patient tolerance.
(1) 尽管已引入用于检查胃肠道且具有高诊断能力的新成像方法,但安全、高效且具成本效益的方法仍在不断改进和实施,胃肠道疾病的诊断仍然具有挑战性;(2) 方法:我们旨在展示在适当准备后,使用多探测器32通道CT扫描仪进行CT结肠成像对结肠疾病早期诊断的可能性;(3) 结果:在早期进行结肠镜检查后,对140例患者进行了CT结肠成像检查。在接受CT结肠成像检查的140例患者中,80例(57.1%)进行了完整结肠镜检查。52例(37.2%)观察到结肠镜检查不完整;5例(3.6%)因禁忌未进行,3例(2.1%)因患者拒绝未进行。我们确定,在95%的患者中完全结肠镜检查的情况下,CT结肠成像得出的临床诊断与结肠镜检查相同。在32.7%(17例)不完整、被拒绝或禁忌的结肠镜检查情况下,结肠镜检查未能正确诊断。结肠镜检查不完整的主要原因是:肿瘤性质的腔内阻塞 - 17例患者(33%),肿瘤形成的腔外阻塞(压迫) - 4例患者(8%),非肿瘤性质的狭窄改变 - 11例患者(21%),肠袢腔长度改变的先天性疾病 - 7例患者(13%),以及13例患者(25%)的主观因素(疼痛、准备不佳、禁忌);(4) 结论:我们的结果证实,在结肠镜检查结果为阴性且伴有肿瘤性病变临床数据的情况下,以及在结肠镜检查不完整和禁忌的情况下,CT结肠成像是一种选择方法。此外,我们开发的充气系统通过提高所获图像质量并确保患者良好耐受性来优化该方法。