Detection of flat lesions in the colon with CT colonography
Detection of flat lesions in the colon with CT colonography
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DOI：
10.1007/s00261-001-0171-z
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发表时间：
2002-05-01
影响因子：
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通讯作者：
Harmsen, WS
中科院分区：
文献类型：
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作者：
Fidler, JL;Johnson, CD;Harmsen, WS
背景资料：我们调查是否可以检测到结肠平坦病变的计算机断层扫描结肠造影（CTC）。方法：CTC和传统的结肠镜检查进行了连续547例。22个息肉的子集在结肠镜检查（n = 16）或CTC（n = 6）中被描述为扁平，这是本报告的基础。CTC采用标准技术（5 mm准直，3 mm重建间隔）进行，患者在仰卧位和俯卧位进行扫描。检查随机分配，并由三名放射科医生中的两名以盲态方式进行审查。记录了前瞻性解释。结果：22例直径0.4 ~ 3.5cm的扁平病灶，组织学分类为腺瘤性（8例）或增生性（14例）。每名审查员检测所有扁平病变和扁平腺瘤的灵敏度分别为43%和100%，65%和100%，15%和13%。“双重阅读”导致68%的所有病变和100%的腺瘤的检测。两个审查员错过了7个增生性息肉，四个被recovery.Conclusion. Flat病变的结肠代表假阴性CTC检查的一个重要来源。了解它们的形态可以帮助放射科医生发现大多数这些具有挑战性的病变。
Background: We investigated whether flat lesions of the colon could be detected on computed tomographic colonography (CTC).Methods: CTC and conventional colonoscopy were performed on 547 consecutive patients. A subset of 22 polyps was described as flat on colonoscopy (n = 16) or CTC (n = 6) and are the basis of this report. CTC was performed with a standard technique (5-mm collimation, 3-mm reconstruction intervals), Patients were scanned in supine and prone positions. Examinations were randomly assigned and reviewed in a blinded fashion by two of three radiologists. Prospective interpretations were recorded. All patients had conventional colonoscopy, which served as the gold standard.Results: Twenty-two flat lesions ranging from 0.4 to 3.5 cm were histologically classified as adenomatous (it = 8) or hyperplastic (n = 14). The sensitivities for detecting all flat lesions and flat adenomas by each reviewer were 43% and 100%, 65% and 100%, and 15% and 13%, respectively. "Double reading" resulted in detection of 68% of all lesions and 100% of adenomas. Of the seven hyperplastic polyps missed by both reviewers, four were identified retrospectively.Conclusion: Flat lesions of the colon represent an important source of false negative CTC examinations. Awareness of their morphology can assist radiologists in finding most of these challenging lesions.