Virtual colonoscopy compared with conventional colonoscopy for stricturing postoperative recurrence in Crohn's disease |
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Authors: | Biancone Livia Fiori Roberto Tosti Claudio Marinetti Alessandro Catarinacci Mario De Nigris Francesca Simonetti Giovanni Pallone Francesco |
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Affiliation: | Cattedra di Gastroenterologia, Dipartimento di Medicina Interna, Center of Excellence for the Study of the Genomic Risk of Complex Multifactoral Diseases, Università di Roma, Rome, Italy. biancone@med.uniroma2.it |
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Abstract: | BACKGROUND: The place of virtual colonoscopy (VC) in patients with Crohn's disease (CD) requiring endoscopic follow-up after surgery is unknown. The authors compared findings from VC versus conventional colonoscopy (CC) for assessing the postoperative recurrence of CD. METHODS: Sixteen patients with ileocolonic anastomosis for CD were prospectively enrolled from January 2001 to January 2002. Recurrence was assessed by CC according to Rutgeerts et al. VC was performed with a computed tomography scanner, with images examined by three radiologists who were unaware of the endoscopic findings. RESULTS: CC showed perianastomotic recurrence in 15 of 16 patients. Perianastomotic narrowing or stenosis was detected by VC in 11 of these 15 patients. There were 11 true positive, 1 true negative, 0 false-positive, and 4 false-negative findings (73% sensitivity, 100% specificity, 100% positive predictive value, 20% negative predictive value, 75% accuracy). Among the eight patients showing a rigid stenosis of the anastomosis not allowing passage of the colonoscope, VC detected narrowing or stenosis in seven patients. CONCLUSIONS: The current findings suggest that although the widespread use of VC in CD is currently not indicated because of possible false-negative findings, this technique may represent an alternative to CC in noncompliant postsurgical patients with a rigid stenosis not allowing passage of the endoscope. |
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