Test-positive rate at CT colonography is increased by rectal bleeding and/or unexplained weight loss, unlike other common gastrointestinal symptoms

Autor: D. Hock, R. Materne, R. Ouhadi, I. Mancini, S.A. Aouachria, A. Nchimi
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Zdroj: European Journal of Radiology Open, Vol 2, Iss C, Pp 32-38 (2015)
Druh dokumentu: article
ISSN: 2352-0477
DOI: 10.1016/j.ejro.2014.12.002
Popis: Purpose: We evaluated the rate of significant colonic and extra-colonic abnormalities at computed tomography colonography (CTC), according to symptoms and age. Materials and methods: We retrospectively evaluated 7361 consecutive average-risk subjects (3073 males, average age: 60.3 ± 13.9; range 18–96 years) for colorectal cancer (CRC) who underwent CTC. They were divided into three groups according to clinical symptoms: 1343 asymptomatic individuals (group A), 899 patients with at least one “alarm” symptom for CRC, including rectal bleeding and unexplained weight loss (group C), and 5119 subjects with other gastrointestinal symptoms (group B). Diagnostic and test-positive rates of CTC were established using optical colonoscopy (OC) and/or surgery as reference standard. In addition, clinically significant extra-colonic findings were noted. Results: 903 out of 7361 (12%, 95% confidence interval (CI) 0.11–0.13) subjects had at least one clinically significant colonic finding at CTC. CTC true positive fraction and false positive fraction were respectively 637/642 (99.2%, 95%CI 0.98–0.99) and 55/692 (7.95%, 95%CI 0.05–0.09). The pooled test-positive rate in group C (138/689, 20.0%, 95%CI 0.17–0.23) was significantly higher than in both groups A (79/1343, 5.9%, 95%CI 0.04–0.07) and B (420/5329, 7.5%, 95%CI 0.07–0.08) (p
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