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Does training and experience influence the accuracy of computed tomography colonography interpretation?

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World Journal of Gastroenterology 2014年第6期20卷 1574-1581页

作者： Greg Rosenfeld Yi Tzu Nancy Fu Brendan Quiney Hong Qian Darin Krygier Jacquie Brown Patrick Vos Pari Tiwari Jennifer Telford Brian Bressler Robert Enns Division of Gastroenterology Department of Medicine University of British Columbia St. Paul’s Hospital Department of Radiology University of British Columbia St. Paul’s Hospital CHEOS St. Paul’s Hospital Division of Gastroenterology Department of Medicine University of British Columbia Royal Columbian Hospital

AIM: To evaluate the effect of experience on the accuracy rate of computed tomography colonography (CTC) interpretation and patient preferences/satisfaction for CTC and colonoscopy.

关键词： computed tomography colonography Colonoscopy Colorectal neoplasia Colorectal cancer screening

Laterally spreading tumors:Limitations of computed tomography colonography

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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).

关键词： computed tomography colonography Laterally spreading tumor Colon neoplasm Advanced lesion Flat adenoma Detection rate

Irritable bowel syndrome evaluation using computed tomography colonography

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World Journal of Gastroenterology 2016年第42期22卷 9394-9399页

作者： Hideki Ohgo Hiroyuki Imaeda Minoru Yamaoka Kazuaki Yoneno Naoki Hosoe Takeshi Mizukami Hidetomo Nakamoto Department of Gastroenterology Saitama Medical University Department of General Internal Medicine Saitama Medical University Center for Diagnostic and Therapeutic Endoscopy School of Medicine Keio University Endoscopy Center NHO Kurihama Medical and Addiction Center

AIM To evaluate the morphology of the colon in patients with irritable bowel syndrome(IBS) by using computed tomography colonography(CTC).METHODS Twelve patients with diarrhea type IBS(IBS-D), 13 patients with constipation type IBS(IBS-C), 12 patients with functional constipation(FC) and 14 control patients underwent colonoscopy following CTC. The lengths of the rectosigmoid colon, transverse colon and the total colon were measured. The diameters of the rectum, sigmoid colon, descending colon, transverse colon, and ascending colon were *** The mean length of the total colon was 156.5 cm in group C, 158.9 cm in group IBS-D, 172.0 cm in group IBS-C, and 188.8 cm in group FC. The total colon in group FC was significantly longer than that in group C(P colonography might contribute the clarification of subtypes of IBS.

关键词： Constipation Irritable bowel syndrome computed tomography colonography

Recent trends in the prevalence and distribution of colonic diverticula in Japan evaluated using computed tomography colonography

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World Journal of Gastroenterology 2021年第27期27卷 4441-4452页

作者： Noriyuki Isohata Koichi Nagata Kenichi Utano Ryoichi Nozaki Satoshi Nozu Takashi Kato Shigeyoshi Kijima Hiroshi Matsumoto Kenichiro Majima Yasuji Ryu Michiaki Hirayama Shungo Endo Department of Coloproctology Fukushima Medical UniversityAizu Medical CenterAizuwakamatsu 969-3492FukushimaJapan Department of Gastroenterology Fukushima Medical UniversityFukushima 960-1295FukushimaJapan Department of Radiology Fukushima Medical UniversityAizu Medical CenterAizuwakamatsu 969-3492FukushimaJapan Department of Gastroenterology Takano HospitalColoproctology CenterKumamoto 862-0971KumamotoJapan Department of Radiology Saitama Cancer CenterIna 362-0806SaitamaJapan Department of Gastroenterology National Hospital Organization Hokkaido Medical CenterSapporo 063-0005HokkaidoJapan Department of Radiology Jichi Medical UniversityShimotsuke 329-0498TochigiJapan Division of Gastroenterology Kawasaki Medical School HospitalKurashiki 701-0192OkayamaJapan Department of Health Management Kameda Medical CenterKamogawa 296-8602ChibaJapan Department of Radiology Tonami General HospitalTonami 939-1395ToyamaJapan Department of Gastroenterology Tonan HospitalSapporo 060-0004HokkaidoJapan

BACKGROUND computed tomography colonography(CTC)may be superior to colonoscopy and barium enema for detecting ***,few studies have used CTC to diagnose *** To evaluate the current prevalence and distribution of colonic diverticula in Japan using *** This study was conducted as part of the Japanese National computed Tomographic colonography Trial,which included 1181 participants from 14 hospitals in *** analyzed the prevalence and distribution of colonic diverticula and their relationships with age and *** relationship between the diverticula and the length of the large intestine was also *** Diverticulosis was present in 48.1%of the *** prevalence of diverticulosis was higher in the older participants(P<0.001 for trend).The diverticula seen in younger participants were predominantly located in the right-sided *** participants had a higher frequency of bilateral type(located in the rightand left-sided colon)diverticulosis(P<0.001 for trend).The length of the large intestine with multiple diverticula in the sigmoid colon was significantly shorter in those without diverticula(P<0.001).CONCLUSION The prevalence of colonic diverticulosis in Japan is higher than that previously *** prevalence was higher,and the distribution tended to be bilateral in older participants.

关键词： computed tomography colonography Diverticulosis Diverticular disease Colon

Single-center study comparing computed tomography colonography with conventional colonoscopy

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World Journal of Gastroenterology 2008年第3期14卷 469-473页

作者： Ian C Roberts-Thomson Graeme R Tucker Peter J Hewett Peter Cheung Ruben A Sebben EE Win Khoo Julie D Marker Wayne K Clapton Department of Gastroenterology The Queen Elizabeth Hospital South Australia Australia Department of Health South Australia Australia Department of Colorectal Surgery The Queen Elizabeth Hospital South Australia Australia Department of Radiology The Queen Elizabeth Hospital South Australia Australia

AIM:To compare the results from computed tomography (CT) colonography with conventional colonoscopy in symptomatic patients referred for colonoscopy. METHODS: The study included 227 adult outpatients, mean age 60 years, with appropriate indications for colonoscopy. CT colonography and colonoscopy were performed on the same day in a metropolitan teaching hospital. Colonoscopists were initially blinded to the results of CT colonography but there was segmental unblinding during the procedure. The primary outcome measures were the sensitivity and specificity of CT colonography for the identification of polyps seen at colonoscopy (i.e. analysis by polyp). Secondary outcome measures included an analysis by patient, extracolonic findings at CT colonography, adverse events with both procedures and patient acceptance and preference. RESULTS: Twenty-five patients (11%) were excluded from the analysis because of incomplete colonoscopy or poor bowel preparation that affected either CT colonography, colonoscopy or both procedures. Polyps and masses (usually cancers) were detected at colonoscopy and CT colonography in 35% and 42% of patients, respectively. Of nine patients with a finaldiagnosis of cancer, eight (89%) were identified by CT colonography as masses (5) or polyps (3). For polyps analyzed according to polyp, the overall sensitivity of CT colonography was 50% (95% CI, 39%-61%) but this increased to 71% (95% CI, 52%-85%) for polyps ≥ 6 mm in size. Similarly, specificity for all polyps was 48% (95% CI, 39%-58%) increasing to 67% (95% CI, 56%-76%) for polyps ≥ 6 mm. Adverse events were uncommon but included one colonic perforation at colonoscopy. Patient acceptance was high for both procedures but preference favoured CT colonography. CONCLUSION: Although CT colonography was more sensitive in this study than in some previous studies, the procedure is not yet sensitive enough for widespread application in symptomatic patients.

关键词： Colorectal polyps Colorectal cancer computed tomography colonography Colonoscopy

Screening of colorectal cancer: Methods and strategies

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World Journal of Clinical Oncology 2024年第7期15卷 799-805页

作者： Zhen Liao Jin-Tao Guo Fan Yang Shu-Peng Wang Si-Yu Sun Department of Gastroenterology Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic TechniquesShengjing Hospital of China Medical UniversityShenyang 110004Liaoning ProvinceChina

Colorectal cancer(CRC)has high incidence and mortality rates,and the em-ergence and application of CRC screening have helped us effectively control the occurrence and development of ***,common international screening methods include tests based on feces and blood,and examination methods that allow for visualization,such as sigmoidoscopy and *** methods have been widely used,whereas others such as multi-target stool RNA test are still being explored and developed,and are expected to become front-line screening methods for CRC in the *** choice of screening method is affected by external conditions and the patients'situation,and the clinician must choose an appropriate strategy according to the actual situation and the patient's *** article introduces various CRC screening methods and analyzes the factors relevant to the screening strategy.

关键词： Colorectal cancer Screening Stool-based test Endoscopic examination computed tomography colonography Blood-based test

Role of preoperative CT colonography in patients with colorectal cancer

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World Journal of Gastroenterology 2014年第14期20卷 3795-3803页

作者： Lapo Sali Massimo Falchini Antonio Taddei Mario Mascalchi Department of Experimental and Clinical Biomedical Sciences University of Florence Department of Surgery and Translational Medicine University of Florence

In patients with colorectal cancer (CRC), accurate preoperative evaluation is essential for a correct therapeutic plan. Colonoscopy and intravenous contrast-enhanced computed tomography (CT) are currently recommended in the preoperative work-up for CRC. Preoperative colonoscopy has some limitations such as misdiagnosis of synchronous cancers in cases of incomplete exploration of the colon and inaccurate tumor localization. Intravenous contrast-enhanced CT successfully documents distant metastases although it sometimes enables unsatisfactory locoregional staging. computed tomography colonography (CTC) is obtained after gas insufflation of the colon and offers a comprehensive preoperative evaluation in patients with CRC, including a definition of the segmental location of the tumor, presence of synchronous lesions or lack thereof, and fairly accurate locoregional staging. CTC has some limitations, including a lack of biopsy capability, suboptimal sensitivity for synchronous small polyps, and unsatisfactory nodal staging. Bearing in mind these limitations, CTC could be employed as a “one-stop-shop” examination for preoperative assessment in patients with CRC.

关键词： Colorectal cancer Colonoscopy computed tomography colonography Synchronous cancer Cancer staging

Rare case of fecal impaction caused by a fecalith originating in a large colonic diverticulum: A case report

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World Journal of Clinical Cases 2021年第2期9卷 416-421页

作者： Hiroki Tanabe Kazuyuki Tanaka Mitsuru Goto Tomonobu Sato Keisuke Sato Mikihiro Fujiya Toshikatsu Okumura Division of Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa 078-8510HokkaidoJapan Department of Gastroenterology Asahikawa Kousei HospitalAsahikawa 078-8211HokkaidoJapan Department of Pathology Asahikawa Kousei HospitalAsahikawa 078-8211HokkaidoJapan

BACKGROUND Fecal impaction is defined as a large mass of compacted feces in the colon and has the potential to induce a serious medical condition in elderly *** impaction is generally preventable,and early recognition of the typical radiological findings is important for making an early *** factors that lead to fecal impaction are usually similar to those causing *** cases with fecal impaction associated with a diverticulum have been *** SUMMARY We present the case of a 62-year-old woman who suffered from abdominal pain and vomiting,had a medical history of repeated acute abdomen and was diagnosed with fecal impaction in the descending colon based on X-ray and computed tomography(CT)*** examination by gastrografinenhanced colonography following colonoscopy and CT colonography,the fecalith was suspected to have been produced at the site of a large diverticulum in the transverse *** fecalith was surgically resected,and a histological diagnosis of pseudodiverticulum was *** was no recurrence during 33 mo of *** This case highlights the importance of accurate identification and treatment of a fecal *** case indicated that the endoscopic evacuation and subsequent colonography were effective for identifying a diverticulum that might have caused fecal impaction.A fecal impaction was associated with the ***,the planned diverticulectomy was *** emergency medical treatment and maintenance treatments should be selected in such cases to prevent recurrence.

关键词： Colonic ileus Constipation Acute abdomen computed tomography colonography Case report Colonoscopy

Virtual gastrointestinal colonoscopy in combination with large bowel endoscopy:Clinical application

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World Journal of Gastroenterology 2014年第38期20卷 13820-13832页

作者： Qing He Ting Rao Yong-Song Guan Department of Oncology West China Hospital of Sichuan University Department of General Surgery West China Hospital of Sichuan University

Although colorectal cancer (CRC) has no longer been the leading cancer killer worldwide for years with the exponential development in computed tomography (CT) or magnetic resonance imaging, and positron emission tomography/CT as well as virtual colonoscopy for early detection, the CRC related mortality is still high. The objective of CRC screening is to reduce the burden of CRC and thereby the morbidity and mortality rates of the disease. It is believed that this goal can be achieved by regularly screening the average-risk population, enabling the detection of cancer at early, curable stages, and polyps before they become cancerous. Large-scale screening with multimodality imaging approaches plays an important role in reaching that goal to detect polyps, Crohn's disease, ulcerative colitis and CRC in early stage. This article reviews kinds of presentative imaging procedures for various screening options and updates detecting, staging and re-staging of CRC patients for determining the optimal therapeutic method and forecasting the risk of CRC recurrence and the overall prognosis. The combination use of virtual colonoscopy and conventional endoscopy, advantages and limitations of these modalities are also discussed. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.

关键词： Colorectal cancer Colorectal polyps Conventional colonoscopy Magnetic resonance colonography computed tomography colonography Positron emission tomography/computed tomography colonography Virtual colonoscopy