Detection of colorectal tumors with water enema-multidetector row computed tomography.
ABSTRACT PURPOSE: To retrospectively determine the diagnostic capabilities of water enema-multidetector row computed tomography (WE-MDCT) in the detection of colorectal tumors. MATERIALS AND METHODS: One hundred and one patients (55 male, 46 female) who had WE-MDCT and videocolonoscopy because of suspected colorectal tumors were included. Results of complete videocolonoscopy, surgery, and histopathologic analysis were used as standard of reference. Sensitivity, specificity, and accuracy, and positive and negative predictive values of WE-MDCT for the diagnosis of colorectal tumors were estimated with 95% confidence intervals (CIs). RESULTS: Ninety-two colorectal tumors (64 malignant, 28 benign) were confirmed in 71 patients (prevalence, 71/101; 70%). Overall sensitivity for colorectal tumor detection was 87% (80/92; 95%CI: 78%-93%) on a per lesion basis. For malignant and benign tumor detection, sensitivity was 100% (64/64; 95%CI: 94%-100%) and 57% (16/28; 95%CI: 37%-76%), respectively. For colorectal tumors ≥10 mm, sensitivity was 99% (76/77; 95%CI: 93%-100%). Seventy-nine of the 83 colorectal tumors ≥6 mm were detected, yielding a sensitivity of 95% (79/83; 95%CI: 88%-99%) for this specific size category. On a per patient basis, WE-MDCT had a sensitivity of 100% (71/71; 95%CI: 94%-100%), a specificity of 100% (30/30; 95%CI: 88%-100%), an accuracy of 100% (101/101; 95%CI: 96%-100%), a positive predictive value of 100% (71/71; 95%CI: 94%-100%), and a negative predictive value of 100% (30/30; 95%CI: 86%-100%) for the diagnosis of colorectal tumor. CONCLUSION: Our results suggest that WE-MDCT is a promising imaging technique for the detection of malignant colorectal tumors. However, our results should be validated by larger and prospective studies.
SourceAvailable from: Philippe Soyer[Show abstract] [Hide abstract]
ABSTRACT: Acute colitis is often diagnosed on multidetector row computed tomography (MDCT) because patients with this condition present with abdominal pain and a variety of nonspecific symptoms. Acute colitis has multiple causes with varying degrees of severity. Analysis of the extent of colonic involvement, presence of specific MDCT imaging features and associated signs should help radiologist narrow the diagnosis. Integrating the results of clinical examination and biological tests is mandatory, and in case of ambiguous or nonspecific MDCT findings, endoscopy and colon biopsy should always be considered for a definite diagnosis. The purpose of this review is to discuss and illustrate MDCT features that are helpful for characterizing acute colitis in adults and to provide an update in current MDCT features.05/2014; 96(2). DOI:10.1016/j.diii.2014.04.008
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ABSTRACT: Une colite aiguë est souvent diagnostiquée au moyen d’un examen tomodensitométrique, car les patients souffrant de cette affection présentent des douleurs abdominales et divers symptômes non spécifiques. Les causes d’une colite aiguë sont multiples, et la sévérité de cette affection est variable. L’analyse de l’étendue de l’atteinte colique, la présence d’aspects spécifiques à la TDM et les signes associés devraient aider le radiologue à restreindre le champ des diagnostics possibles. L’intégration des résultats de l’examen clinique et des analyses biologiques est obligatoire et, en cas d’observations ambiguës ou non spécifiques à la TDM, une endoscopie et une biopsie colique doivent toujours être envisagées pour un diagnostic définitif. L’objectif de cet article est de discuter et d’illustrer des aspects TDM utiles pour la caractérisation d’une colite aiguë chez l’adulte.05/2014; 96(1). DOI:10.1016/j.jradio.2014.03.013
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ABSTRACT: Water-enema multidetector computed tomography (WE-MDCT) is a technique for the localization and preoperative T- and N-stage assessments of colon cancer. It may be a useful tool for planning surgery. The primary aim of this study was to evaluate the diagnostic accuracy of WE-MDCT for T-staging and its ability to locate tumors for laparoscopy planning. The secondary aim was to assess reading reproducibility and diagnostic accuracy for the preoperative determination of N-stage. We performed a study to evaluate preoperative WE-MDCT for surgical planning in patients with symptomatic colon adenocarcinomas who underwent surgery between June 2010 and January 2014. A radiologist and a surgeon read the WE-MDCTs separately. Results were compared with colonoscopy and the surgical specimen. Seventy-one patients (42 men (59.1 %); mean age 73.1 years (range 45 to 95)) were included. Seventy-six tumors were assessed. The intraclass correlation coefficient (ICC) for location as determined by surgery and that determined by WE-MDCT was 1, and the ICC for location between colonoscopy and WE-MDCT was 0.85 (95 % CI 0.75-0.91). For T-stage determination, sensitivity was 96 and 94 % and specificity 83 and 88 % for readers 1 and 2, respectively. The T-stage assessment allowed for the programing of surgical access and showed good sensitivity and specificity for the assessment of invasion in adjacent organs. WE-MDCT is relatively easy to perform, and its results can be read effectively by radiologists and surgeons. WE-MDCT indicated the location of tumors perfectly and permitted a good determination of their T-stage. The technique is thus pertinent for the planning of laparoscopic surgery for colon cancer.International Journal of Colorectal Disease 02/2015; 30(5). DOI:10.1007/s00384-015-2172-3 · 2.42 Impact Factor