Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults
Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults
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DOI：
10.1056/nejmoa031618
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发表时间：
2003-12-04
影响因子：
158.5
通讯作者：
Schindler, WR
中科院分区：
文献类型：
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作者：
Pickhardt, PJ;Choi, JR;Schindler, WR
背景：我们评估了计算机断层扫描 (CT) 虚拟结肠镜检查在平均风险筛查人群中检测结直肠肿瘤的性能特征。方法：共有 1233 名无症状成年人（平均年龄 57.8 岁）在当天接受了虚拟结肠镜检查和光学结肠镜检查。放射科医生使用三维腔内显示器在 CT 虚拟结肠镜检查中初步检测息肉。对于每个结肠段的初步检查，结肠镜检查人员并不知道虚拟结肠镜检查的结果，这些结果是在随后的重新检查之前向他们透露的。以最终非盲光学结肠镜检查结果为参考标准，计算虚拟结肠镜检查的敏感性和特异度以及光学结肠镜检查的敏感性。结果：虚拟结肠镜检查对于直径≥10mm的腺瘤性息肉的敏感性为93.8%，对于直径≥8mm的息肉为93.9%， 直径至少 6 毫米的息肉为 88.7%。光学结肠镜检查对三种尺寸息肉的腺瘤性息肉的敏感性分别为87.5%、91.5%和92.3%。虚拟结肠镜检查腺瘤性息肉的特异性对于直径至少 10 毫米的息肉为 96.0%，对于直径至少 8 毫米的息肉为 92.2%，对于直径至少 6 毫米的息肉为 79.6%。两个息肉是恶性的；两者均在虚拟结肠镜检查中检出，其中一个在虚拟结肠镜检查结果显示之前在光学结肠镜检查中漏掉了。结论：采用三维方法的 CT 虚拟结肠镜检查是无症状平均风险成人结直肠肿瘤的准确筛查方法，在检测临床相关疾病方面优于光学结肠镜检查。 病变。
BACKGROUND:We evaluated the performance characteristics of computed tomographic (CT) virtual colonoscopy for the detection of colorectal neoplasia in an average-risk screening population.METHODS:A total of 1233 asymptomatic adults (mean age, 57.8 years) underwent same-day virtual and optical colonoscopy. Radiologists used the three-dimensional endoluminal display for the initial detection of polyps on CT virtual colonoscopy. For the initial examination of each colonic segment, the colonoscopists were unaware of the findings on virtual colonoscopy, which were revealed to them before any subsequent reexamination. The sensitivity and specificity of virtual colonoscopy and the sensitivity of optical colonoscopy were calculated with the use of the findings of the final, unblinded optical colonoscopy as the reference standard.RESULTS:The sensitivity of virtual colonoscopy for adenomatous polyps was 93.8 percent for polyps at least 10 mm in diameter, 93.9 percent for polyps at least 8 mm in diameter, and 88.7 percent for polyps at least 6 mm in diameter. The sensitivity of optical colonoscopy for adenomatous polyps was 87.5 percent, 91.5 percent, and 92.3 percent for the three sizes of polyps, respectively. The specificity of virtual colonoscopy for adenomatous polyps was 96.0 percent for polyps at least 10 mm in diameter, 92.2 percent for polyps at least 8 mm in diameter, and 79.6 percent for polyps at least 6 mm in diameter. Two polyps were malignant; both were detected on virtual colonoscopy, and one of them was missed on optical colonoscopy before the results on virtual colonoscopy were revealed.CONCLUSIONS:CT virtual colonoscopy with the use of a three-dimensional approach is an accurate screening method for the detection of colorectal neoplasia in asymptomatic average-risk adults and compares favorably with optical colonoscopy in terms of the detection of clinically relevant lesions.