Colonic distention at screening CT colonography: role of spasmolytic agents and body habitus.
Sufficient colonic dilation is important when using CT colonography (CTC) for colorectal cancer screening. We investigated the effect of antispasmodic agents and the patient body habitus on the degree of colonic dilation in screening CTC.We assessed the effect of clinical characteristics [age, gender, body mass index (BMI), and the presence of diverticula] and the use of antispasmodics on colonic distention in 140 patients who underwent CTC for colorectal cancer screening. The CTC was performed in both the supine- and prone positions. Seventy patients received antispasmodics prior to CT examination and the other 70 did not. Colonic distention was scored using a 5-point scale: 1=collapsed, 2=poorly visualized, 3=visualized but underdistended, 4=acceptable, and 5=excellent. Images scored as 4 or 5 were considered to be of diagnostic quality. The mean visual evaluation score was significantly higher in the supine- than the prone position (4.2±0.5 vs. 4.0±0.5, p<0.01). For the supine position, only the use of antispasmodic was statistically associated with sufficient colonic dilation by univariate logistic analysis (odds ratio=2.365, p=0.03). For the prone position, age, BMI, and the use of antispasmodic were statistically associated with sufficient colonic dilation by multivariate analysis. The odds ratio of these parameters was 0.955 (p=0.02), 0.874 (p=0.03), and 2.391 (p=0.02), respectively.We obtained sufficient colonic dilation with an antispasmodic for CTC in both positions. Younger age and a lower BMI were also associated with better colonic dilation in the prone position.
Department of Radiology, Saiseikai Kumamoto Hospital.
Takashi
T
Sakamoto
Daisuke
D
Utsunomiya
Katsuhiko
K
Mitsuzaki
Katsuhiko
K
Matsuda
Megumi
M
Kawakami
Sadahiro
S
Yamamura
Joji
J
Urata
Akihiko
A
Arakawa
Yasuyuki
Y
Yamashita
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003106:Colon / Q000000981:diagnostic imaging* / Q000187:drug effects*; D023881:Colonography, Computed Tomographic / Q000379:methods*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D016017:Odds Ratio; D010276:Parasympatholytics / Q000008:administration & dosage; D056888:Patient Positioning; D011237:Predictive Value of Tests; D016684:Prone Position; D011446:Prospective Studies; D012737:Sex Factors; D016683:Supine Position
D010276:Parasympatholytics