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The value of MDCT colonoscopy in the evaluation of lesions of the large intestine

  • Clinical Study
  • Published:
Hellenic Journal of Surgery

Abstract

Aim-Backgroun|

The aim of this study is to illustrate our experience of Virtual Colonoscopy (VC) for investigation of lesions of the large intestine in patients with iron deficiency anaemia, comparing its results to those from classical colonoscopy. Colorectal cancer (CRC) is the third most common cancer and the second leading cause of death in the United States. Several options have been developed as screening methods, each with its advantages and drawbacks. Optical colonoscopy (OC) is currently the gold standard for evaluation of the entire colonic mucosa, possessing the therapeutic capacity for resecting detected lesions. Virtual Colonoscopy has evolved as a result of technological advances in imaging and, specifically, in computed tomography.

Patients-Methods

During a period of 6 months, 46 patients (22 women and 24 men with an average age of 57, 3 ± 13.3 years) with iron deficiency anaemia underwent virtual colonoscopy using multislice computed tomography. The results were compared with classic colonoscopy, which was considered the method of choice.

Results

Multidetetcor-CT (MDCT) virtual colonoscopy diagnosed neoplasm in 6 (13%) patients, polyps in 11 patients (24%) and diverticulae in 12 patients (26%). Classic colonoscopy performed in the above-mentioned patients confirmed neoplasms in 5 patients, polyps in 13 patients and diverticulae in 11 patients. The positive predictive value of MDCT for neoplasms, polyps and diverticula corresponds with 83.3%, 71.4% and 92.3% respectively. The sensitivity and the specificity is 83.3% and 97% for neoplasms, 71% and 96% for polyps and 92% and 100% for diverticulae, respectively. The accuracy of the method is calculated at 84.8%.

Discussion

Virtual Colonoscopy (VC) was introduced in 1994. It is a non-invasive method of imaging that allows us to explore the colon by employing a spiral CT. The method is safe and can be used where normal colonoscopy is contraindicated or unsuccessful, such as in patients receiving anticoagulants, those in whom the use of anaesthetics would pose risks or in patients presenting dolichocolon, adhesions or diverticulae. The most encouraging indication for VC is CRC screening. Our study demonstrated that the results of VC performed in our patients were comparable to those demonstrated in previously published studies.

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Authors and Affiliations

  1. 1st Surgical Department, General Hospital “Asklepieion Voulas”, Athens, Greece

    D. Gkiouzelis, K. Biliri, D. Skouteris, G. Katsou & M. Digalakis

  2. Department of Computed Tomography, General Hospital “Asklepieion Voulas”, Athens, Greece

    A. Balanika, G. Hesketh, G. Galani & N. Tserpes

Authors
  1. D. Gkiouzelis
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  2. K. Biliri
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  3. A. Balanika
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  4. G. Hesketh
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  5. G. Galani
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  6. N. Tserpes
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  7. D. Skouteris
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  8. G. Katsou
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  9. M. Digalakis
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Correspondence to D. Gkiouzelis.

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Gkiouzelis, D., Biliri, K., Balanika, A. et al. The value of MDCT colonoscopy in the evaluation of lesions of the large intestine. Hellenic J Surg 83, 252–257 (2011). https://doi.org/10.1007/s13126-011-0048-8

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  • DOI: https://doi.org/10.1007/s13126-011-0048-8

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