Zusammenfassung
Diese Übersicht stellt die verfügbaren Daten zur CT-Kolographie zusammen und diskutiert
sowohl die technischen als auch medizinischen Aspekte der Entwicklung der letzten
10 Jahre. Obwohl prinzipiell gleichermaßen mit CT wie MRT möglich, wird vorwiegend
auf die CT-Technik eingegangen. Die Entwicklung der CT-Technik zum sog. Multi-Detektor-Reihen-CT
wird dargestellt und der Einfluss unterschiedlicher Untersuchungstechniken (Schichtdicke,
Dosis, Patientenvorbereitung, Nachverarbeitung) erläutert.
Die Methode hat eine hohe Sensitivität, Spezifität und einen hohen negativen Vorhersagewert
für Polypen ≥ 1 cm, wobei sie bisher unbefriedigend für Polypen < 5 mm abschneidet.
Sie ist eine valide Ergänzung bei inkompletter konventioneller Endoskopie sowie eine
Alternative zu „Hochrisiko”-Endoskopien. In der Zukunft wird sie möglicherweise eine
Alternative zur konventionellen Endoskopie im Rahmen von Screening-Programmen auf
kolorektale Karzinome darstellen.
Abstract
This article reviews published data regarding CT colonography and discusses both technical
and medical aspects of its development over the last 10 years. Although colonography
can be performed using MRI instead of CT, mainly CT aspects are dealt with. The technical
development of CT to the current generation of Multi-detector-row-CT is explained,
and the influence of various factors (slice thickness, dose, patient preparation,
post processing) is discussed.
The method has a high sensitivity and specifity as well as a high negative predictive
value for the detection of polyps ≥ 1 cm, but is currently still insufficient in the
detection of polyps < 5 mm. It is a valid alternative after incomplete optical colonoscopy
and an alternative in patients with “high-risk” for conventional endoscopy. In the
future it may become an alternative for conventional endoscopy in screening programms
for colorectal cancer.
Schlüsselwörter
CT-Kolonographie - Kolon - Polypen - Screening - Kolonkarzinom
Key words
CT colonography - colon - polyps - screening - colon carcinoma
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PD Dr. med. Andrik J. Aschoff
Leitender Oberarzt, Abt. Röntgendiagnostik, Universitätsklinikum Ulm
Steinhövelstraße 9
89075 Ulm
Phone: ++ 49/7 31/5 00-2 74 30
Fax: ++ 49/7 31/5 00-2 66 92
Email: andrik.aschoff@medizin.uni-ulm.de
