Dataset Information

Three-dimensional reconstruction of computed tomography colonography discloses anatomic features associated with colonoscopy failure.

ABSTRACT:

Objectives

Three-dimensional virtual reality (3D VR) permits precise reconstruction of computed tomography (CT) images, and these allow precise measurements of colonic anatomical parameters. Colonoscopy proves challenging in a subset of patients, and thus CT colonoscopy (CTC) is often required to visualize the entire colon. The aim of the study was to determine whether 3D reconstructions of the colon could help identify and quantify the key anatomical features leading to colonoscopy failure.

Design

Retrospective observational study.

Methods

Using 3D VR technology, we reconstructed and compared the length of various colonic segments and number of bends and colonic width in 10 cases of CTC in technically failed prior colonoscopies to 10 cases of CTC performed for non-technically failure indications.

Results

We found significant elongation of the sigmoid colon (71 ± 23 cm versus 35 ± 9; p = 0.01) and of pancolonic length (216 ± 38 cm versus 158 ± 20 cm; p = 0.001) in cases of technically failed colonoscopy. There was also a significant increase in the number of colonic angles (17.7 ± 3.2 versus 12.7 ± 2.4; p = 0.008) in failed colonoscopy cases.

Conclusion

Increased sigmoid and pancolonic length and more colonic bends are novel factors associated with technical failure of colonoscopy.

SUBMITTER: Hochstein D

PROVIDER: S-EPMC10031618 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Three-dimensional reconstruction of computed tomography colonography discloses anatomic features associated with colonoscopy failure.

Hochstein David D Tejman-Yarden Shai S Saukhat Olga O Vazgovski Oliana O Parmet Yisrael Y Nagar Netanel N Ram Edward E Carter Dan D

Therapeutic advances in gastroenterology 20230321

<h4>Objectives</h4>Three-dimensional virtual reality (3D VR) permits precise reconstruction of computed tomography (CT) images, and these allow precise measurements of colonic anatomical parameters. Colonoscopy proves challenging in a subset of patients, and thus CT colonoscopy (CTC) is often required to visualize the entire colon. The aim of the study was to determine whether 3D reconstructions of the colon could help identify and quantify the key anatomical features leading to colonoscopy fail ...[more]

PMID: 36968619

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Project description:BackgroundIdentifying cardioembolic stroke is important for the decision-making of endovascular treatment and anticoagulation therapy. We aimed to explore the features of cardioembolic stroke on 4-dimensional (4D) computed tomography angiography (4D-CTA) and assess whether these features can assist in classifying stroke etiology.MethodsIn this retrospective study, we analyzed the images of 294 patients with acute ischemic stroke (AIS) from July 2020 to February 2022 at the First Affiliated Hospital of Chongqing Medical University, which had been consecutively collected. The data of 110 patients with occlusion of the M1/M2 segment of the middle cerebral artery (MCA) with/without intracranial internal carotid artery (ICA) occlusion were analyzed to calculate the clot burden score (CBS) and collateral score (CS), and the data of 88 patients with a clear origin and distal part were analyzed to measure clot length. Maximum intensity projection (MIP) and time MIP (tMIP) post-processing were used to assess the clot features. The Mann-Whitney U test was used to compare the clot characteristics between the 2 groups. Binary logistic regression was performed to assess the association between the image characteristics and cardioembolic stroke. Moreover, the receiver operating characteristic (ROC) curve was used to test the diagnostic efficacy of MIP/tMIP clot features in classifying cardioembolic stroke.ResultsAge, high-risk factors for cerebrovascular disease, high/medium-risk sources of cardioembolic stroke, clot length, CBS, and CS were significantly different between the cardioembolic stroke group and non-cardioembolic stroke group (P<0.05). In the cardioembolic stroke group, the median MIP and tMIP clot length was 12 mm [interquartile range (IQR), 8.3-17.4 mm] and 9.3 mm (IQR, 6.8-14.3 mm), respectively. In the non-cardioembolic stroke group, the median MIP and tMIP clot length was 6.5 mm (IQR, 4.7-11.5 mm) and 5.8 mm (IQR, 3.9-10.6 mm), respectively. Binary logistic regression showed that cardioembolic stroke was significantly associated with MIP-clot length [odds ratio (OR), 1.15; 95% confidence interval (CI): 1.02-1.29; P<0.05], tMIP-clot length (OR, 1.18; 95% CI: 1.02-1.36; P<0.05), and tMIP-CBS (OR, 3.96; 95% CI: 1.08-14.58; P<0.05). The area under the ROC curve (AUC) values of MIP clot length for identifying cardioembolic stroke were 0.75 (95% CI: 0.65-0.84, P<0.05), with a cut-off value of >7.4 mm [sensitivity: 84.62% (95% CI: 69.50-94.10%); specificity: 59.18% (95% CI: 44.20-73.00%)]. The AUC value of tMIP clot length was 0.72 (95% CI: 0.61-0.81, P<0.05), with a cut-off value of >5.4 mm [sensitivity: 92.31% (95% CI: 79.10-98.40%); specificity: 48.98% (95% CI: 34.40-63.70%)].ConclusionsClot length and CBS were overestimated on MIP images. Among the clot characteristics, clot length could identify cardioembolic stroke.

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Dataset Information

Three-dimensional reconstruction of computed tomography colonography discloses anatomic features associated with colonoscopy failure.

Objectives

Design

Methods

Results

Conclusion

Publications

Three-dimensional reconstruction of computed tomography colonography discloses anatomic features associated with colonoscopy failure.

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