Keywords:
Patterns of Care, Outcomes, Endoscopy, Ultrasound, Conventional radiography, CT, Gastrointestinal tract, Colon, Abdomen
Authors:
D. Tzias, C. Alexakis, P. Patel, S. Moodie; London/UK
DOI:
10.1594/ecr2013/C-0401
Results
159 colonoscopies were performed,
over a period of 12 months as a result of abnormalities reported following imaging.
32 were excluded due to unavailable imaging.
Sex
|
Number of colonoscopies
|
Mean age
|
Male
|
55
|
65(18-96) |
Female
|
72
|
68(23-92) |
Table 1.
Demographics- Percentages in brackets
Of the imaging techniques leading to colonoscopy,
CT had been used 98 out of 127 (77%) of the times.
The other modalities used are detailed in Table 2.
Imaging
|
Number(%)
|
CT Pneumocolon
|
17(14)
|
CT
|
98(77)
|
Ultrasound
|
3(2)
|
Barium studies
|
4(3)
|
MRI
|
5(4)
|
Table 2.
Imaging leading to colonoscopy-Percentages in brackets
The commonest indication that had lead to the CT scan was abdominal pain.(Table 3)
Indication
|
Number(%)
|
Weight loss
|
10(10)
|
Anaemia
|
7(7)
|
Abdominal pain
|
31(32)
|
PR bleed
|
8(8)
|
Mass
|
4(4)
|
Change in bowel habit
|
19(19)
|
Other
|
19(19)
|
Total
|
98(100)
|
Table 3.
Indications for CT -Percentages in brackets
In 71% of the colonoscopies,
an abnormality was described in the location reported on CT.
In 43% of cases,
colonoscopy confirmed the exact luminal pathology reported on CT.
Of these cases,
62% were reported as tumour/mass lesion and 24% as diverticular disease.
CT report
|
Total Number(100%)
|
Confirmation by colonoscopy(43%)
|
Other abnormality on colonoscopy(28%)
|
Normal Colonoscopy(29%)
|
Tumour/mass
|
38(39)
|
26(62)
|
5(18)
|
7(25)
|
NSBWT
|
35(36)
|
2(5)
|
16(57)
|
17(61)
|
Colitis
|
4(4)
|
3(7)
|
1(3)
|
0(0)
|
Diverticular disease
|
13(13)
|
10(24)
|
0(0)
|
3(11)
|
Polyps
|
1(1)
|
0(0)
|
0(0)
|
1(3)
|
Other
|
7(7)
|
1(2)
|
6(21)
|
(0)0
|
Total
|
98(100)
|
42(100)
|
28(100)
|
28(100)
|
Table 4.
Comparison of reported CT abnormalities and subsequent colonoscopic findings- Percentages in brackets
Where there was discrepancy between radiological and endoscopic findings,
the most common pathology reported on CT was non-specific bowel wall thickening(NSBWT).
However,
there was still an abnormality in 51% of colonoscopies following CT reporting NSBWT,
including 1 malignancy and 6 polyps.
In the “high confidence” group,
there was significantly higher rate of confirmation of CT reported findings by colonoscopy(59%),
than in the “low confidence” group(20%),
(p<0.001).
|
"High" Confidence Group (%)
|
"Low" Confidence Group (%)
|
Confirmation by Colonoscopy(43%)
|
34(59) |
8(20) |
Discrepancy between CT and Colonoscopy(57%)
|
24(41) |
32(80) |
Total
|
58(100) |
40(100) |
Table 5.
Comparison between confidence groups-Percentages in brackets