Transabdominal ultrasound colonography in the diagnosis of colon polyps
Shcherbina O.V. , Koval O.V., Zhaivoronok M.M.
Summary. Adenomatous serrated colon polyps have a risk of turning into cancer. Colorectal screening methods can prevent and reduce cancer mortality. Objective. To assess the possibilities of transabdominal ultrasonography in the diagnosis of colon polyps. Materials and methods. The results of transabdominal ultrasonography were analyzed in 74 patients in whom a colon polyp was diagnosed during histological analysis of the materials. The age of the examinees varied from 31 to 78 years, among them 46 (62.2%) men and 28 (37.8%) women. The results. A total of 172 polyps were detected — of them 33 (19.2±3.0%) in the ascending, 23 (13.4±2.6%) in the transverse, 47 (27.3±3.4%) in the descending and 69 (40.1±3.7%) in the sigmoid colon. The number of polyps in the sigmoid colon was significantly (p <0.01) higher than in other departments of the colon. In 75 (43.6±3.8%) cases, the size of polyps was less than 10 mm, in 97 (56.4±3.8%) cases — more than 10 mm (p <0.05). The number of polyps <10 mm in size in the ascending colon was 12 (16.0±4.2%), in the group with polyps >10 mm — 21 (21.6±4.2%), in the transverse colon — 6 (8.0±3.1%) and 17 (17.5±3.9%), in descending colon — 19 (25.3±4.9%) and 28 (28.9±4.6%), and in sigmoid colon — 38 (50.7±5.8%) and 31 (32.0±4.7%), respectively. Only in the sigmoid colon, the number of detected polyps with sizes <10 mm significantly (p <0.05) exceeded the number of polyps with sizes >10 mm. In 79 (45.9±3.8%) cases polyps were with the pedicle, in 93 (54.1±3.8%) cases were sessile. In the ascending colon, 13 (36.4±8.4%) were with pedicle, 20 (63.6±8.4%) were sessile (p <0.05). For transverse colon, these parameters were 6 (26.1±9.2%) and 17 (73.9±9.2%) (p <0.001), for descending colon — 16 (34.0±7.1%) and 31 (66.0±7.1%) (p <0.001), and for the sigmoid colon — 41 (59.4±5.9%) and 28 (40.6±5.9%) pieces. Only in the sigmoid colon, the number of detected polyps on the pedicle significantly (P <0.01) exceeded the number of sessile polyps. Adenomatous polyps in 47 (40.3±4.5%) cases were with pedicle, in 72 (59.7±4.5%) — sessile (p <0.05), glandular polyps in 32 (60, 4±6.7%) of cases were with pedicle, in 21 (39.6±6.7%) — sessile (p <0.05). During ultrasound, adenomatous polyps with pedicle were detected in 46 (97.9±2.1%) of 47 cases, sessile polyps — in 64 (88.9±3.7%) of 72 cases, glandular polyps with pedicle — in 31 (96.9±3.1%) out of 32 cases, sessile polyps — in 15 (71.4±9.9%) out of 21 cases, respectively. Polyps with pedicle during USG were detected significantly (p <0.05) better than sessile polyps. During USG, polyps in the ascending colon were detected in 27 (81.8±6.7), in the transverse colon — in 18 (78.3±8.6), in the descending colon — in 44 (93.6±3.6%), in sigmoid colon — in 67 (97.1±2.0%) cases, respectively. The frequency of detection of polyps in the sigmoid colon during ultrasound was significantly higher (p <0.05) than in the ascending and transverse colon. The sensitivity of USG in the diagnosis of adenomatous polyps was 87.4%, specificity — 66.7%, accuracy — 86.4%. In the diagnosis of glandular polyps, these parameters were 92.5; 80.0, and 91.4%, respectively. Conclusions. The average number of colon polyps in the elderly is significantly (p <0.05) greater than in the young. Ultrasonographically, polyps of the sigmoid colon are detected significantly (p <0.05) more often than those of the ascending and transverse colon. The sensitivity of sonographic colonography in the diagnosis of adenomatous polyps is 87.4%, glandular polyps — 92.5%, with the size of polyps <10 mm — 86.7%, >10 mm — 92.8%, respectively.
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