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2015 ; 9
(4
): TC14-8
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gab.com Text
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English Wikipedia
Role of CT Colonography in Colonic Lesions and Its Correlation with Conventional
Colonoscopic Findings
#MMPMID26023619
Singh K
; Narula AK
; Thukral CL
; Singh NR
; Singh A
; Kaur H
J Clin Diagn Res
2015[Apr]; 9
(4
): TC14-8
PMID26023619
show ga
BACKGROUND: Preoperative evaluation in patients with colorectal carcinoma is
essential for a correct therapeutic plan. Conventional colonoscopy has certain
limitations including its inability to detect synchronous lesions in case of
distal obstructive mass and inaccurate tumour localization. CT colonography
combines cross sectional imaging with virtual colonoscopic images and offers a
comprehensive preoperative evaluation in patients with colorectal carcinoma
including detection of synchronous lesions with accurate segmental localization
and loco regional staging. AIM: The objective was to determine the role of CT
colonography in various colonic lesions and to correlate the findings with
conventional colonoscopy and histopathological findings. SETTINGS AND DESIGN:
This prospective study included 50 patients with clinical symptoms suspicious of
colonic pathology. MATERIALS AND METHODS: All the patients underwent both CT
colonography and conventional colonoscopy on the same day. CT colonography was
performed in supine and prone position. Considering histopathological and/or
surgical findings as gold standard, sensitivity and specificity of both the
modalities were calculated. RESULTS: Conventional colonoscopy missed two
synchronous lesions proximal to occlusive mass and one lesion proximal to the
anastomotic site; all were detected with CT colonography. One carpet lesion in
rectum and one case of mild ulcerative colitis were missed by CT colonography.
Sensitivity and specificity for detection of colorectal cancer were 97.56% and
100%, resp. with PPV and NPV of 100% and 93.75%, for CT colonography and 92.68%
and 100%, respectively with PPV and NPV of 100% and 83.3% for conventional
colonoscopy. Sensitivity for correct detection of acute and chronic ulcerative
colitis of CT colonography was 66.6 % and 100 %, resp. CONCLUSION: CT
colonography has higher sensitivity than conventional colonoscopy for detection
of colorectal carcinoma, including its ability to detect abnormalities proximal
to obstructing lesion, accurate segmental localization of lesions and staging.
However, some limitations of CT colonography were difficulty in detection of flat
lesions and lack of information about hyperemia and superficial mucosal erosion,
where conventional colonoscopy scored over CT colonography.