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KMID : 1131320150170010033
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Journal of Korean Society of Computed Tomographic Technology
2015 Volume.17 No. 1 p.33 ~ p.42
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A Study on Reduction of Examination Time and Decrease of RepeatsUsing Catheter Equipped with Auxiliary Cap in CT Colonography
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Seo Kyeong-Jin
Jin Eun-Jung
Lim Seung-Hyeon
Joh Yeong-Ho
Kim Yeong-Nam
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Abstract
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Purpose : CT Colonography delivers an accurate diagnosis when the colon is sufficiently expanded, but causes problems in the examination by the leakage of gas when CO2 gas is injected into the anus.The catheter balloon used in the examination is possible to prevent the leakage, but it is not enough for patients with abnormal anal sphincter function causing gas leakage and increase of repeats and patients dose. Therefore, This purpose of our study was to minimize the anus gas leakage through rectal Manometry test and the use of Catheter equipped with an auxiliary cap so that our study examine whether the examination time can be shortened, number of repeats can be reduced and the patient does can be deducted.
Materials and methods : For this study, We used Somatom Sensation 16 MDCT(Siemens, Erlangen, Germany) and Automatic CO2 Colon Insufflator(EZEM, New York, USA) with 20 Fr Foley Catheter(2-way standard,30 mL/cc balloon) to inject CO2 gas. The auxiliary cap was inserted at the intervals of 1.5 cm at the location of balloon of the catheter using a fill cap of a 1,000 mL dispensing bottle used by our own hospital. At the hospital from January 13 to 2014 through April 30, 2013, Among The hospital in patients scheduled toundergo surgeries for rectal & sigmoid colon cancers, 110 patients above the age of 60 who completed both Rectal Manometry test which are the objective testing of anal sphincter function and CTColonography test were chosen as the study objects. The CTC test method is a dual testing of prone and supine where testing time differences between the first and the last topogram are compared and the number of repeats is analyzed to differentiate between cases of the auxiliary cap use and non-use according to three categories of anal sphincter normality, findings of bowel obstruction and Buscopan injection.
Results : When an auxiliary cap was not used and it was used, In the case of abnormal sphincters, the testing time was 4 minutes when an auxiliary cap was not used and 2.2 minutes when it was used. In the case of findings of bowel obstruction, the testing time was 6 minutes and 4 minute. In the case of absence of Buscopan, the testing time was 4.25 minutes and 2.2 minutes and shortened the testing time to 45%, 33% and 48% respectively in each category when an auxiliary cap was used and All the statistics revealed to be relevant. In the case of abnormal anal sphincter, the number of repeats was from 0.38 times to 0.2 times. In the case of finding of bowel obstruction, it was from one time to 0.44 times. In the absence of Buscopan, the number of repeats was from 0.6 times to 0.4 times. The number of repeats dropped by 47%, 56% and 33% respectively in each category when an auxiliary cap was used.
Conclusions : The use of catheter equipped with an auxiliary cap in CTC examination resulted in shortening examination time and the number of repeats. This facilitated an expansion of anal sphincter not only in healthy patients but also in patients with abnormal anal sphincter and findings of bowel obstruction to improve the quality of images, reduce patient dose and failure rate of tests.Especially, it can produce great effects in patients with anorectal surgery patients who are known to lose 90% of anal function, therefore the procedure is likely to produce even better images which is highly valuable clinically when it is applied to such patients.
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KEYWORD
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CT colonography, Foley Catheter, Rectal Manometry, Anal sphincter Function, Bowel obstruction, Buscopan
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