전자선전산화단층촬영을 이용한 가상대장경 : 바륨관장검사,대장경검사 및 병리소견과의 비교

Abstract

Purpose : To perform virtual colonoscopy using electron beam tomography(EBT) in patients in whom a colonic mass was present, and to compare the results with those obtained using barium enema, colonoscopy and gross pathologic specimens. Materials and Methods : Ten patients in whom colonic masses were diagnosed by either barium enema or colonoscopy were involved in this study. There were nine cases of adenocarcinoma and one of tubulovillous adenoma. Using EBT preoperative abdominopelvic CT scans were performed. Axial scans were then three-dimensionally reconstructed to produce virtual colonoscopic images and were compared with barium enema, colonoscopy and gross pathologic specimens. Virtual colonoscopic images of the masses were classified as either 1) polypoid, 2) sessile, 3) fungating, or 4) annular constrictive. We also determined whether ulcers were present within the lesions and whether there was obstruction. Results : After virtual colonoscopy, two lesions were classified as polypoid, one as sessile, five as fungating and two as annular constrictive. Virtual colonoscopic images showed good correlation with the findings of barium enema, colonoscopy and gross pathologic specimens. Three of six ulcerative lesions were observed on colonoscopy; in seven adenocarcinomas with partial or total luminal obstruction, virtual colonoscopy visualized the colon beyond the obstructed sites. In one case, barium contrast failed to pass through the obstructed portion and in six cases, the colonoscope similarly failed. Conclusion : Virtual colonoscopies correlated well with barium enema, colonoscopy and gross patholoic specimens. They provide three dimensional images of colonic masses and are helpful for the evaluation of obstructive lesions.