Bilgisayarlı tomografide görülen gastrointestinal sisteme ait bulgular ile endoskopi veya kolonoskopide görülen bulguların karşılaştırması
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Dosyalar
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada BT'deki gastrointestinal sisteme ait bulgular ile endoskopi/kolonoskopi bulgularını karşılaştırmayı, işlem sırasında gereğinde alınan biyopsilerin sonucunu değerlendirmeyi ve aradaki ilişkiyi hesaplamayı amaçladık. Ocak 2011-Eylül 2019 tarihleri arasında Selçuk Üniversitesi Tıp Fakültesi Radyoloji kliniğinde herhangi bir sebeple batın BT çekilen, BT'de gastrointestinal sisteme (özofagus, mide, ince barsak, kolon) ait bulgular görülen ve yine aynı hastalara Selçuk Üniversitesi Tıp Fakültesi Gastroenteroloji kliniğinde endoskopi veya kolonoskopi işlemi yapılan hastalar retrospektif olarak incelendi. BT'de herhangi bir bulgu görülmeyen ancak endoskopi veya kolonoskopide BT'de de tespit edilebilecek bulgular görülen hastalar da çalışmaya dahil edildi. BT ile endoskopi/kolonoskopi arasında 3 aydan fazla süre olan hastalar çalışmaya dahil edilmedi. Kontrastsız çekim yapılan BT'ler, artefaktlı çekimler çalışmaya dahil edilmedi. Endoskopi/kolonoskopide optimal değerlendirme yapılamayan (barsak temizliği yetersizliği, midede gıda artıklarının bulunması gibi) hastalar çalışmaya dahil edilmedi. Sonuçta çalışmaya 136 erkek, 114 kadın olmak üzere 250 hasta alındı. Gerekli istatistiksel analizler SPSS paket programı 21.0 versiyonu kullanılarak yapıldı. Yaptığımız çalışmada endoskopi/kolonoskopi işlemi altın standart olarak kabul edildiğinde; BT'nin özofagustaki maligniteyi tespit etmede sensitivitesi %12,5 spesifitesi %88,9 pozitif prediktif değeri %50 negatif prediktif değeri %53'tür. BT'nin midedeki maligniteyi tespit etmede sensitivitesi %26 spesifitesi %90 pozitif prediktif değeri %60 negatif prediktif değeri %68'dir. BT'nin ince barsaktaki maligniteyi tespit etmede sensitivitesi %50 spesifitesi %88 pozitif prediktif değeri %25 negatif prediktif değeri %95,7'dir. BT'nin kolondaki maligniteyi tespit etmede sensitivitesi %43,2 spesifitesi %97,1 pozitif prediktif değeri %84,2 negatif prediktif değeri %82,9'dur. BT'nin kolondaki divertikülü tespit etmede sensitivitesi %41,6 spesifitesi %95,8 pozitif prediktif değeri %66,7 negatif prediktif değeri %88,9'dur. BT'nin kolondaki polipi tespit etmede sensitivitesi %10 spesifitesi %98,4 pozitif prediktif değeri %50 negatif prediktif değeri %86,9'dur. Sonuç olarak her ne kadar BT gastrointestinal sisteme ait patolojileri ortaya koymada yüksek öngörüye sahip olsa da saptanan bulguların endoskopi veya kolonoskopi ile ileri inceleme yapılması gerekmektedir.
In this research we purpose to compare findings of the gastrointestinal system in CT with the findings in endoscopy/colonoscopy to evaluate the results of the biopsis taken during the procedure and calculate their relationship. Patients who got a abdomen CT scan for any reason between January 2011-September 2019 at the department of clinical radiology of the University Hospital Selcuk in which were observed findings of the gastrointestinal tract (esophagus, stomach, small intestine, colon) and who carried out an endoscopy or colonoscopy at the Selcuk University Gastroenterology clinic were examined retrospectively. The study includes patients, whose CT-screenings did not show any remarkable results, but whose colonoscopic or endoscopic examinations showed positive findings, which should have been seen on the CT-screening either. Patients who have more than 3 months between their CT screening and endoscopic/colonoscopic procedure were not involved. Non-contrast CT, images with artefacts were excluded. Endoscopy/colonoscopy of patients with non-optimal conditions (deficient cleansing of the gastrointestinal tract, food residue in the stomach) for the evaluation were not included, Eventually altogether 250 patients, thereof 136 men and 114 women, were involved. For the statistical anlaysis was used the SPSS package program 21.0. If we accept the endoscopy/colonoscopy procedure as the gold standart in our examination; the sensitivity of CT in detecting malignancy in the esophagus is 12.5% specificity is 88.9% positive predictive value is 50% negative predictive value is 53%. The sensitivity of CT to detecting malignancy in the stomach is 26% specificity is 90% positive predictive value is 60% negative predictive value is 68%. The sensitivity of CT in detecting malignancy in the small intestine is 50% specificity is 88% positive predictive value is 25% negative predictive value is 95.7%. The sensitivity of CT in detecting malignancy in the colon is 43.2% specificity is 97.1% positive predictive value is 84.2% negative predictive value is 82.9%. The sensitivity of CT to detect diverticulum in the colon is 41.6% specificity is 95.8% positive predictive value is 66.7% negative predictive value is 88.9%. The sensitivity of CT in detecting the polyp in the colon is 10% specificity is 98.4% positive predictive value is 50% negative predictive value is 86.9%. In conclusion the reports should be examined by using endoscopy/colonoscopy altough the CT screening has a high prediction in showing evidence of pathologies of the gastrointestinal tract.
In this research we purpose to compare findings of the gastrointestinal system in CT with the findings in endoscopy/colonoscopy to evaluate the results of the biopsis taken during the procedure and calculate their relationship. Patients who got a abdomen CT scan for any reason between January 2011-September 2019 at the department of clinical radiology of the University Hospital Selcuk in which were observed findings of the gastrointestinal tract (esophagus, stomach, small intestine, colon) and who carried out an endoscopy or colonoscopy at the Selcuk University Gastroenterology clinic were examined retrospectively. The study includes patients, whose CT-screenings did not show any remarkable results, but whose colonoscopic or endoscopic examinations showed positive findings, which should have been seen on the CT-screening either. Patients who have more than 3 months between their CT screening and endoscopic/colonoscopic procedure were not involved. Non-contrast CT, images with artefacts were excluded. Endoscopy/colonoscopy of patients with non-optimal conditions (deficient cleansing of the gastrointestinal tract, food residue in the stomach) for the evaluation were not included, Eventually altogether 250 patients, thereof 136 men and 114 women, were involved. For the statistical anlaysis was used the SPSS package program 21.0. If we accept the endoscopy/colonoscopy procedure as the gold standart in our examination; the sensitivity of CT in detecting malignancy in the esophagus is 12.5% specificity is 88.9% positive predictive value is 50% negative predictive value is 53%. The sensitivity of CT to detecting malignancy in the stomach is 26% specificity is 90% positive predictive value is 60% negative predictive value is 68%. The sensitivity of CT in detecting malignancy in the small intestine is 50% specificity is 88% positive predictive value is 25% negative predictive value is 95.7%. The sensitivity of CT in detecting malignancy in the colon is 43.2% specificity is 97.1% positive predictive value is 84.2% negative predictive value is 82.9%. The sensitivity of CT to detect diverticulum in the colon is 41.6% specificity is 95.8% positive predictive value is 66.7% negative predictive value is 88.9%. The sensitivity of CT in detecting the polyp in the colon is 10% specificity is 98.4% positive predictive value is 50% negative predictive value is 86.9%. In conclusion the reports should be examined by using endoscopy/colonoscopy altough the CT screening has a high prediction in showing evidence of pathologies of the gastrointestinal tract.
Açıklama
Anahtar Kelimeler
Bilgisayarlı Tomografi, Endoskopi, Gastrointestinal Sistem, Kolonoskopi, Computered Tomography, Endoscopy, Gastrointestinal System, Colonoscopy
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Durmuş, H. (2020). Bilgisayarlı tomografide görülen gastrointestinal sisteme ait bulgular ile endoskopi veya kolonoskopide görülen bulguların karşılaştırması. (Uzmanlık Tezi). Selçuk Üniversitesi, Tıp Fakültesi, Konya.
