Computed tomographic (CT) colonography allows the visualization of extracolonic organs, thereby permitting the detection of potentially significant pathologies beyond the colon. Extracolonic lesions are found in 15%-85% of cases, with some being important lesions, such as extracolonic cancer or aortic aneurysm. Early detection of extracolonic lesions is an aim of CT colonography. In particular, the detection of significant lesions is very important. However, the incidence rates of significant extracolonic lesions vary from country to country, and most reports relate to the Western population.
A research team led by Dr Dong Il Park from Korea determine the frequency and characteristics of extracolonic lesions detected using CT colonography. Their study will be published on March 28, 2009 in the World Journal of Gastroenterology.
Extracolonic lesions were divided into three categories, according to their significance. Highly significant lesions include those requiring immediate surgical therapy, medical intervention and/or further investigation. Lesions of intermediate significance include conditions that do not require immediate therapy but would likely require further investigation, recognition or therapy at a later time. Lesions of low significance include benign conditions that do not require further medical therapy or additional work-up.
A total of 920 consecutive subjects (men/women = 535/385) were analyzed. Six hundred and ninety two extracolonic findings were found in 532 (57.8%) subjects, and 60 (8.7%) highly significant, 250 (36.1%) intermediate significant and 382 (55.2%) low significant lesions were detected. When factors related to the clinical significance of extracolonic findings were analyzed, older age (P <0.001), being female (P = 0.001), presence of symptoms (P < 0.001) and the use of contrast during CT colonography (P = 0.003) were associated with detection of the more significant extracolonic lesions.
Based on these results, it could be concluded that most of the extracolonic lesions detected by CT colonography were lesions of low significance. Careful case selection and use of contrast enhancement would increase the effectiveness of exam. This study is helpful to clinicians to determine the best way to use the CT colonography for detecting highly significant extracolonic lesions.
Reference: Park SK, Park DI, Lee SY, Lee SK, Kim YH, Lee SJ, Byeon JS, Huh KC, Shim KN. Extracolonic findings of computed tomographic colonography in Koreans. World J Gastroenterol
2009; 15(12): 1487-1492
http://www.wjgnet.com/1007-9327/15/1487.asp
Correspondence to: Dong Il Park, MD, PhD, Department of Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital 108, Pyung-dong, Jongro-gu, Seoul 110-746, South Korea. diksmc.park@samsung.com
About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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World Journal of Gastroenterology