De Lázaro y de Molina S, Marco-Doménech SF, Casanovas-Feliu E, Gaona- Morales J

Language: Spanish
References: 35
Page: 177-193
PDF size: 608.55 Kb.

ABSTRACT

Objetive: review the results of colonographies by tomography (or virtual colonoscopies) performed in our service and compare them with those in the literature.
Material and Method: we reviewed virtual colonoscopies performed over 4 years. All patients were prepared with low-residue diet 72 hours before the test, marking stool with oral Gastrografin^™ and mechanical insufflation of the colon with CO₂. The studies were performed with a 64-detector tomograph, by the low-kilovoltage technique. Images were processed in 3D and 2D, and follow-up with optical colonoscopy, surgery on neoplasms and polyps detected, or both.
Results: 750 virtual colonoscopies were performed; 410 patients were referred for the procedure following an incomplete optical colonoscopy, 178 patients were symptomatic with contraindication or risk of optical colonoscopy and 122 in screening, and 40 (5%) could not be evaluated; 408 (55%) were normal and 302 (40%) were pathological. Of the pathological virtual colonoscopies, we found neoplastic processes in 139 patients and in 13 a neoplastic process synchronous with sensitivity, specificity, and prevalence of colorectal cancer of 99, 95, and 3.8%, respectively. Also, follow-up was performed with optical colonoscopy and pathological anatomy of 229 polyps with sensitivity, specificity, and positive predictive value of 94, 95, and 89%, respectively, which increased to 100, 99.5, and 97% when we studied polyps ≥ 10 mm.
Conclusion: virtual colonoscopy is a useful exploration with clear indications, after optical colonoscopies are incomplete, for any reason, in symptomatic patients with contraindications or risks in performing optical colonoscopies and in screening programs for colon cancer.

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