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Endoluminal CT colonography after an incomplete endoscopic colonoscopy
M M Morrin1, J B Kruskal, R J Farrell
1Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
AJR. American Journal of Roentgenology
|December 10, 1999
Summary
Endoluminal CT colonography is a useful tool for visualizing the colon when colonoscopy is incomplete. This rapid, well-tolerated imaging technique successfully revealed the unvisualized colon in over 90% of patients.
Area of Science:
- Medical Imaging
- Gastroenterology
- Diagnostic Technology
Background:
- Colonoscopy is a primary tool for colorectal examination.
- Incomplete colonoscopies present a diagnostic challenge.
- Alternative imaging modalities are needed for cases where colonoscopy fails.
Purpose of the Study:
- To evaluate the clinical utility of endoluminal CT colonography (CTC) following incomplete colonoscopy.
- To assess CTC's effectiveness in visualizing previously unreached colonic segments.
- To compare CTC with barium enema in terms of diagnostic yield and patient tolerance.
Main Methods:
- Prospective study of 40 patients with incomplete colonoscopies.
- Endoluminal CT colonography performed within 2 hours of failed colonoscopy.
- Analysis of 2D multiplanar reformatted and 3D endoluminal images; comparison with barium enema in 26 patients.
Main Results:
- Endoluminal CT colonography duration averaged 14.2 minutes.
- CTC was better tolerated than colonoscopy or barium enema (p < .001).
- CTC identified reasons for incomplete colonoscopy in 74% of patients and visualized 96% of colonic segments, surpassing barium enema (91%, p < .05).
Conclusions:
- Endoluminal CT colonography is a rapid, well-tolerated, and effective method for completing the colonic examination after incomplete colonoscopy.
- CTC provides valuable colonic and extracolonic information.
- Consider CTC for all patients with incomplete colonoscopies.