Estratto
La colonscopia virtuale (CV), oltre a consentire un’eccellente visualizzazione del colon, permette d’identificare reperti extra-colici in sede addominale e pelvica [1, 2]. E ciò, se da una parte può essere considerato un valore aggiunto della metodica, dall’altra rappresenta un vero e proprio dilemma, nel senso che non è chiaro se questo sia realmente un vantaggio, in particolare per le possibili implicazioni medico-legali, etiche ed economiche [3, 4]. In altri termini, l’acquisizione di una scansione dell’addome e della pelvi determina necessariamente un ulteriore lavoro del radiologo, rappresentato da una seconda analisi delle immagini con finestra idonea allo studio dei parenchimi, per evitare di tralasciare reperti che possano avere una ricaduta medico-legale ed etica. D’altra parte, bisogna anche capire se l’individuazione di lesioni clinicamente non significative generi solo un ulteriore senso di ansia nel paziente e un costo aggiuntivo per la CV, dovuto alla richiesta di altri esami diagnostici e laboratoristici necessari per caratterizzare con certezza un reperto, e se, per esempio, il riscontro di una neoplasia maligna (es. un carcinoma del pancreas) non produca solo un cosiddetto lead-time bias, ovverosia un’anticipazione diagnostica, di nessun beneficio per la gestione e la prognosi del paziente, ma solo fonte di ulteriore stress emotivo [1, 2].
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Iafrate, F., Celestre, M., Laghi, A. (2008). Reperti extra-colici: Prevalenza e impatto clinico. In: La colonscopia virtuale. Springer, Milano. https://doi.org/10.1007/978-88-470-1067-3_14
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DOI: https://doi.org/10.1007/978-88-470-1067-3_14
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