Subscribe to RSS
DOI: 10.1055/s-2003-45363
© Georg Thieme Verlag Stuttgart · New York
CT-Kolonographie: Diagnostik kolorektaler Polypen und Tumoren
CT Colonography: Diagnostic of Colorectal Polypes and TumorsPublication History
Publication Date:
15 December 2003 (online)
Zusammenfassung
Frühzeitige Erkennung und Therapie des kolorektalen Karzinoms sind unverzichtbare Grundlagen, um die hohe Mortalität zu senken. Die sog. CT-Kolonographie wird im zunehmenden Maße als mögliche alternative Untersuchungsmethode zum Nachweis von kolorektalen Polypen und Karzinomfrühformen betrachtet. Der folgende Beitrag liefert neben dem klinischen Hintergrund einen Überblick über die Durchführung einer CT-Kolonographie einschließlich in der Praxis erprobter Untersuchungsprotokolle. Insbesondere Patientenvorbereitung sowie Verarbeitung der Bilddaten und deren Interpretation werden erläutert. Weiterhin werden der derzeitige Stellenwert, Indikation sowie Vor- und Nachteile dieser Methode beleuchtet.
Abstract
Early recognition and therapy of the colorectal carcinoma are an indispensable basis to lower the high mortality. The so-called CT colonography is increasingly regarded as a possible alternative method to find colorectal polyps and early forms of colorectal cancer. In addition to a review of the clinical background, the following article provides an overview of how to perform CT colonography including clinically established examination protocolls. In particular, patient preparation as well as the processing of the imaging data and their interpretation are described. Furthermore, present role and indications as well as advantages and disadvantages of this method are discussed.
Key words
Colon, CT; - Colon neoplasms, CT; - Intestinal neoplasms, diagnosis; - Cancer screening; - Contrast media
Literatur
-
1 Angela H, Schatzkin A G.
Cancer: rates and risks, 4th ed. Bethesda, MD National Cancer Institute (National Institutes of Health publication no. 96-691);. 1996: 129-135 - 2 Callstrom M R, Johnson C D, Fletcher J G, Reed J E, Ahlquist D A, Harmsen W S, Tait K, Wilson L A, Corcoran K E. CT colonography without cathartic preparation: feasibility study. Radiology. 2001; 219 (3) 693-698
- 3 Dachman A H, Kuniyoshi J K, Boyle C M. et al . CT colonography with three-dimensional problem solving for detection of colonic polyps. Am J Roentgenol. 1998; 171 989-995
- 4 Fenlon H M, Nunes D P, Schroy P C, Barish M A, Clarke P D, Ferrucci J T. A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps. N Engl J Med. 1999; 341 1496-1503
- 5 Gluecker T M, Johnson C D, Harmsen W S. et al . Colorectal Cancer Screening with CT Colonography, Colonoscopy, and Double-Contrast Barium Enema Examination: Prospective Assessment of Patient Perceptions and Preferences. Radiology. 2003; 227 (2) 378-384
- 6 Greenlee R T, Murray T, Bolden S, Wingo P A. Cancer statistics, 2000. CA Cancer J Clin. 2000; 50 7-33
- 7 Hara A K, Johnson C D, MacCarty R L, Welch T J, McCollough C H, Harmsen W S. CT colonography: Single-versus Multi-Detector Row Imaging. Radiology. 2001; 219 461-465
- 8 Hara A K, Johnson C D, Reed J E. et al . Detection of colorectal polyps with CT colonography: initial assessment of sensitivity and specificity. Radiology. 1997; 205 59-65
- 9 Kronborg O, Fenger C, Olsen J, Jorgensen O D, Sondergaard O. Randomised study of screening for colorectal cancer with faecal-occult-blood test. Lancet. 1996; 348 1467-1471
- 10 Lefere P A, Gryspeerdt S S, Dewyspelaere J. et al . Dietary fecal tagging as a cleansing method before CT colonography: initial results polyp detection and patient acceptance. Radiology. 2002; 224 393-403
- 11 Marshall J B, Barthel J S. The frequency of total colonoscopy and terminal ileal intubation in the 1990 s. Gastrointest Endosc. 1993; 39 518-520
- 12 Nusko G, Mansmann U, Altendorf-Hofmann A. et al . Risk of invasive carcinoma in colorectal adenomas assessed by size and site. Int J Colorectal Dis.. 1997; 12 (5) 267-271
- 13 Rex D K, Cutler C S, Lemmel G T. et al . Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. Gastroenterology.. 1997; 112 24-28
- 14 Wessling J, Fischbach R, Domagk D, Luegering N, Neumann E, Heindel W. Colorectal polyps: Detection with multi-slice CT colonography. Röfo.. 2001; 173 1069-1071
- 15 Wessling J, Fischbach R, Meier N. et al . CT colonography: Protocol optimization with multi-detector CT - a study in an anthropomorphic colon phantom. Radiology.. 2003; 228 (3) 753-759
- 16 Winaver S J, Zauber A G, Ho M N, O’Brian M J. et al . Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med. 1993; 329 1977-1981
- 17 Yee J, Akerkar G A, Hung R K, Steinauer-Gebauer A M, Wall S D, McQuaid K R. Colorectal Neoplasia: Performance Characteristics of CT Colonography for detection in 300 patients. Radiology. 2001; 219 685-692
- 18 Yee J, Hung R K, Akerkar G A, Wall S D. The usefulness of glucagon hydrochloride for colonic distention in CT colonography. Am J Roentgenol. 1999; 173 (1) 169-172
- 19 Yee J, Kumar N N, Hung R K, Akerkar G A, Kumar P R, Wall S D. Comparison of supine and prone scanning separately and in combination at CT colonography. Radiology. 2003; 226(3) 653-661
Korrespondenzadresse
Dr. med. Johannes Wessling
Institut für Klinische Radiologie Universitätsklinikum Münster
Albert-Schweizer-Straße 33
48149 Münster
Phone: +49 251 8347-302
Fax: +49 251 8347-312
Email: weslingj@uni-muenster.de