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CT-Kolonographie: Pathologische Befunde und Pitfalls

CT colonography: pathologic findings and pitfalls

Zusammenfassung

Die Kolonographie mittels Multidetektorcomputertomographie (MDCT; CT-Kolonographie) ist eine leistungsfähige Methode zur Detektion und Klassifikation kolorektaler Läsionen. Sie beruht auf der Anfertigung eines CT-Datensatzes mit einer rekonstruierten Schichtdicke von 0,75–2 mm. Die akquirierten Daten werden dann zu zwei- und dreidimensionalen Bildern verarbeitet. Die Auswertung eines CT-Kolonographie-Datensatzes basiert auf der Detektion und korrekten Interpretation von Läsionen und Füllungsdefekten des Kolons. Zur richtigen Interpretation von Füllungsdefekten und zur Differenzierung von echten Läsionen und Pseudoläsionen bedarf es verschiedener Kriterien. Dazu zählen v. a. die äußere Form, die innere Struktur, das Kontrastmittelaufnahmeverhalten und die Lagestabilität von Läsionen. Die Kenntnis morphologischer und struktureller Charakteristika echter Läsionen und Pseudoläsionen des Kolons ist eine Vorrausetzung zur richtigen Interpretation eines Füllungsdefekts. In diesem Übersichtsartikel werden die MDCT-Charakteristika von Polypen, Divertikeln, Lipomen und Karzinomen sowie von häufigen Pseudoläsionen des Kolons zusammengefasst.

Abstract

Thin-section multidetector-row computed tomographic (MDCT) colonography is a powerful tool for detection and classification of colonic lesions. It is based on a helical thin-section (0.75–2 mm) CT dataset of the cleansed and air-distended colon. 2D and 3D projections are prepared and used for image interpretation. Evaluation of CT colonography datasets requires correct perception and interpretation of colonic lesions and filling defects. Various criteria are needed for correct interpretation of filling defects and differentiaton between genuine lesions and artifacts. Such defects are characterized by their morphology, their structure, the absorption of contrast medium and their mobility. Knowledge of the morphologic and attenuation characteristics of common colonic lesions and of artifacts is essential for the correct interpretation of a filling defect. This review article summarizes the main imaging features of polyps, diverticula, lipomas, and carcinomas and also of common pseudolesions of the colon.

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Mang, T., Graser, A., Maier, A. et al. CT-Kolonographie: Pathologische Befunde und Pitfalls. Radiologe 48, 146–155 (2008). https://doi.org/10.1007/s00117-007-1614-5

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  • DOI: https://doi.org/10.1007/s00117-007-1614-5

Schlüsselwörter

  • CT-Kolonographie
  • Polyp
  • Kolorektales Karzinom
  • Lipom
  • Divertikel
  • Pitfalls

Keywords

  • CT colonography
  • Polyp
  • Colorectal cancer
  • Lipoma
  • Diverticula
  • Pitfalls