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Laterally spreading tumors:Limitations of computed tomography colonography

World Journal of Gastroenterology 2014年第46期20卷 17552-17557页

作者： Kazutomo Togashi Kenichi Utano Shigeyoshi Kijima Yosuke Sato Hisanaga Horie keijirou sunada Alan T Lefor Hideharu Sugimoto Yoshikazu Yasuda Department of Coloproctology Aizu Medical CenterFukushima Medical UniversityAizuwakmatsu-cityFukushima 969-3492Japan Department of Surgery Jichi Medical UniversityShimotsukeTochigi 329-0498Japan Department of Radiology Jichi Medical UniversityShimotsukeTochigi 329-0498Japan Department of Gastroenterology Jichi Medical UniversityShimotsukeTochigi 329-0498Japan

AIM:To prospectively investigate the detection rate of laterally spreading tumors(LSTs)of the colorectum by computed tomography(CT)colonography(CTC).METHODS:Patients with LSTs measuring≥20 mm detected during colonoscopy were prospectively enrolled in the study.All patients underwent colonoscopy and subsequent CTC on the same day.CTC was performed using multi-detector CT without contrast in the prone and supine positions.Two radiologists blinded to the existence of LSTs read the virtual endoscopic images as well as 2-D images.LSTs were classified into granular and non-granular types based on colonoscopic appearance.RESULTS:Forty-seven pathologically proven LSTs were evaluated prospectively.Histology included adenomas in 19,mucosal cancers in 19 and T1 cancers in 9.The mean diameter of the LSTs was 35.1 mm.Twenty-eight(60%)LSTs were correctly identified by CTC,and the configuration was similar to the colonoscopic appearance in most cases.Detection rate for the granular type was significantly higher than that for the nongranular type(71%vs 31%,P=0.013).Detection rate of adenomas was significantly lower than mucosal cancers(32%vs 79%,P=0.008)and T1 cancers(32%vs 78%,P=0.042).CONCLUSION:The detection rate of LSTs by CTC,particularly the non-granular type was not acceptable.Practitioners should be aware of the relatively low detection rate when using CTC.

关键词： Computed tomography colonography Laterally spreadi

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