Document Detail


CT colonography for incomplete or contraindicated optical colonoscopy in older patients.
MedLine Citation:
PMID:  18094304     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our purpose was to assess the performance of CT colonography (CTC) in patients older than 60 years who were referred because colonoscopy was contraindicated or incomplete. MATERIALS AND METHODS: Over a 2-year period, 61 patients underwent CTC at our institution, 42 of whom (26 women, 16 men) were 60 years old or older (range, 60-87 years; mean age, 71 years). After 24-48 hours of ingesting only clear liquids and after colonic cleansing, fecal tagging, and automated CO2 insufflation, patients were scanned using a 16-MDCT scanner. Images were obtained with the patient in the supine and prone positions and as needed in the right or left decubitus position. Axial 2D and 3D endoluminal views were evaluated on a dedicated workstation. RESULTS: Contraindications to colonoscopy in 12 (29%) of the 42 patients were as follows: anticoagulation (n = 8), increased anesthesia risk (n = 3), and poor tolerance for colonoscopy preparation (n = 1). Incomplete colonoscopy in the other 30 patients (71%) was due to diverticular disease (n = 10), colonic redundancy (n = 10), adhesions (n = 3), residual colonic content (n = 3), sigmoid stricture (n = 1), ventral hernia (n = 1), and unknown cause (n =2). No complications were observed. Optimal distention of the entire colon was achieved in 38 patients (90%). Thirty-nine (93%) of the 42 patients had abnormal findings: diverticular disease (n = 25), one or more polyps (n = 22), a mass lesion (n = 1), a lipoma (n = 1), and inflammatory stricture (n = 1). Extracolonic findings potentially requiring further evaluation or treatment were observed in 26 patients (62%). CONCLUSION: CTC using CO2 insufflation was well tolerated and successful in imaging the entire colon in most of the 42 patients, despite the presence of sigmoid diverticular disease or colonic redundancy.
Authors:
Cem Yucel; Anna S Lev-Toaff; Nicole Moussa; Haroon Durrani
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  190     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-20     Completed Date:  2008-01-14     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  145-50     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Thomas Jefferson University Hospital, 132 S 10th St., Main Bldg., Ste. 763L, Philadelphia, PA 19107, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Barium / diagnostic use
Colonic Polyps / radiography*
Colonography, Computed Tomographic*
Colonoscopy / contraindications*
Colorectal Neoplasms / prevention & control,  radiography*
Contrast Media
Enema
Female
Humans
Male
Middle Aged
Pneumoradiography / methods
Chemical
Reg. No./Substance:
0/Contrast Media; 7440-39-3/Barium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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