Extracolonic and incidental findings on CT colonography (virtual colonoscopy)
Extracolonic and incidental findings on CT colonography (virtual colonoscopy)
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DOI：
10.2214/ajr.182.3.1820631
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发表时间：
2004-03-01
影响因子：
5
通讯作者：
Lasson, A
中科院分区：
文献类型：
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作者：
Hellström, M;Svensson, MH;Lasson, A
客观的。我们研究的目的是前瞻性地确定有症状患者 CT 结肠成像结肠外发现的频率和临床重要性。 主题和方法。 111 名有症状且转诊接受结肠镜检查的患者在结肠镜检查前接受了 CT 结肠成像。直肠充气后，患者取仰卧位和俯卧位，进行从膈肌到联合的螺旋CT检查。图像解释是在数字工作站上完成的。根据潜在的临床重要性，结肠外发现被分为轻微、中度或严重。对患者记录进行审查，并进行约 3 年的随访，以确定最终诊断。 结果。 26 名 (23%) 的患者有重要的 CT 发现，例如淋巴结肿大 (n = 7)、主动脉瘤 (n = 6)、疑似肝脏实性肿块 (n = 5) 和疑似肾脏实性肿块 (n = 4)。 58 名患者 (52%) 具有中等重要性的发现，例如胆结石 (n = 16)、不确定的肾脏肿块 (n = 9)、外观良性的肾上腺肿块 (n = 8) 和食管裂孔疝 (n = 7)。 46 名患者 (41%) 没有或仅有轻微发现，例如肾囊肿 (n = 34)、肾钙化 (n = 19) 和肝囊肿 (n = 14)。对患者记录的审查表明，CT 结肠成像有助于检测 111 名患者中的 14 名 (13%) 患者是否存在以前未知的主要结肠外疾病。结论。 23% 的患者发现了潜在重要的结肠外发现，导致需要额外的诊断或治疗考虑。其中一些发现具有临床重要意义，而另一些发现是以前已知的或导致不必要的检查。当考虑将 CT 结肠成像用于常规诊断检查或筛查时，必须考虑到这一发现。
OBJECTIVE. The objective of our study was to prospectively determine the frequency and clinical importance of extracolonic findings on CT colonography in symptomatic patients.SUBJECTS AND METHODS. One hundred eleven symptomatic patients referred for colonoscopy underwent CT colonography before colonoscopy. Helical CT from the diaphragm to the symphysis was performed with the patient in the supine and prone positions after rectal air insufflation. Image interpretation was done on a digital workstation. Extracolonic findings were classified as minor, moderate, or major according to potential clinical importance. Patient records, with a follow-up time of about 3 years, were reviewed to determine final diagnoses.RESULTS. Twenty-six (23%) of the patients had CT findings of major importance such as lymphadenopathy (n = 7), aortic aneurysm (n = 6), suspected solid hepatic masses (n = 5), and suspected solid renal masses (n = 4). Fifty-eight patients (52%) had findings of moderate importance such as gallstones (n = 16), indeterminate renal masses (n = 9), adrenal masses with benign appearance (n = 8), and hiatal hernia (n = 7). Forty-six patients (41%) had no or only minor findings, such as renal cysts (n = 34), renal calcifications (n = 19), and hepatic cysts (n = 14). Review of patient records showed that CT colonography contributed to the detection of major, previously unknown extracolonic disorders in 14 (13%) of the 111 patients.CONCLUSION. Potentially important extracolonic findings were revealed in 23% of the patients, leading to additional diagnostic or therapeutic considerations. Some of these findings were clinically important, whereas others were previously known or led to unnecessary workup. This finding must be taken into account when CT colonography is considered for routine diagnostic workup or screening.