CT colonoscopy of colorectal neoplasms: two-dimensional and three-dimensional virtual-reality techniques with colonoscopic correlation.
CT colonoscopy of colorectal neoplasms: two-dimensional and three-dimensional virtual-reality techniques with colonoscopic correlation.
复制标题
结直肠肿瘤的 CT 结肠镜检查：具有结肠镜相关性的二维和三维虚拟现实技术。
DOI：
10.2214/ajr.169.5.9353434
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
J. Ferrucci
中科院分区：
文献类型：
--
作者：
A. Royster;H. Fenlon;P. Clarke;D. Nunes;J. Ferrucci
目的
本研究的目的是比较二维（2D）CT结肠成像和三维（3D）虚拟结肠镜检查与传统结肠镜检查在疑似结直肠肿瘤患者中的诊断准确性。
受试者和方法
研究了20名患者（8名女性和12名男性;平均年龄，53岁;范围，42-85岁）。所有患者的常规结肠镜检查结果提示结直肠癌，并在内窥镜检查后3小时内进行结肠CT检查。二维CT结肠成像和三维虚拟结肠镜图像是从相同的数据集，从腹部和骨盆的薄层螺旋CT直肠吹入室内空气后获得的。通过将CT数据下载到配备有商业可用软件的工作站来获得三维虚拟结肠镜图像。体积和透视渲染技术被用来实现交互式的，三维虚拟的“飞越”检查结肠粘膜。将2DCT结肠成像和3D仿真结肠镜的结果与常规结肠镜的结果进行比较，并在可能的情况下与手术和病理结果相关联。
结果
在我们的研究组中确定了20个肿块（定义为直径大于或等于2 cm的腔内投影）和15个息肉（定义为直径小于2 cm的投影）。2D结肠造影成功显示所有肿块和15个息肉中的14个。在2D结肠造影中，3例息肉的发现为假阳性，1例为假阴性。三维仿真结肠镜显示20个肿块中的19个，15个息肉中的13个。在常规结肠镜检查中，所有20个肿块和15个息肉中的13个都被识别出来，其中一个假阳性发现是正常结肠的恶性狭窄。使用2D技术的20名患者中有18名患者和使用3D虚拟结肠镜的20名患者中有17名患者可以完全检查结肠，而传统结肠镜检查仅显示20名患者中的12名患者的整个结肠。
结论
二维CT结肠成像和三维仿真结肠镜检查是互补的和有效的技术检查可疑大肠癌患者的结肠。与传统结肠镜检查相比，CT技术具有几个优点，包括能够检测梗阻癌近端的异常，结肠内异常的准确定位以及良好的患者耐受性。这些CT技术可能在未来的结直肠癌诊断和筛查高危患者中发挥重要作用。
OBJECTIVE
The aim of this study was to compare the diagnostic accuracy of two-dimensional (2D) CT colonography and three-dimensional (3D) virtual colonoscopy with conventional colonoscopy in patients who have suspected colorectal neoplasms.
SUBJECTS AND METHODS
Twenty patients were studied (eight women and 12 men; mean age, 53 years; range, 42-85 years). All patients had findings on conventional colonoscopy suggestive of colorectal carcinoma and underwent colonic CT within 3 hr of endoscopy. Two-dimensional CT colonography and 3D virtual colonoscopy images were generated from the same data set that was obtained from thin-section helical CT of the abdomen and pelvis after rectal insufflation of room air. Three-dimensional virtual colonoscopy images were obtained by downloading CT data to a workstation equipped with commercially available software. Volume- and perspective-rendering techniques were used to achieve interactive, 3D virtual "fly-through" examinations of the colonic mucosa. The results of 2D CT colonography and 3D virtual colonoscopy were compared with the findings of conventional colonoscopy and correlated with surgical and pathologic outcome where possible.
RESULTS
Twenty masses (defined as intraluminal projections 2 cm or larger in diameter) and 15 polyps (defined as projections smaller than 2 cm in diameter) were identified in our study group. All masses and 14 of 15 polyps were successfully shown on 2D colonography. Three findings of polyps on 2D colonography were false-positive, and one was false-negative. Three-dimensional virtual colonoscopy revealed 19 of 20 masses and 13 of 15 polyps. On conventional colonoscopy, all 20 masses and 13 of 15 polyps were identified, with one false-positive finding of a malignant stricture in a normal colon. Complete examination of the colon was possible in 18 of 20 patients using the 2D technique and in 17 of 20 patients using 3D virtual colonoscopy, whereas conventional colonoscopy showed the entire colon in only 12 of 20 patients.
CONCLUSION
Two-dimensional CT colonography and 3D virtual colonoscopy are complementary and effective techniques for examining the colon in patients with suspected colorectal carcinoma. CT techniques offer several advantages over conventional colonoscopy including the ability to detect abnormalities proximal to obstructing carcinomas, accurate localization of abnormalities within the colon, and good patient tolerance. These CT techniques may play an important role in future diagnosis of colorectal cancer and for screening patients at risk.