To verify the knowledge and interest of general practitioners on computed tomography colonography (CTC).

IntroductionEvidence from HIV‐negative cohorts suggests a link between osteoporosis and cardiovascular disease. We evaluated the presence and distribution of abdominal aortic calcifications (AAC) and its correlation with bone mineral density (BMD) and vertebral fractures (VF) in a cohort of HIV‐positive patients.Materials and MethodsIn this cross‐sectional study, 280 asymptomatic HIV‐positive patients from the SPID (“San Paolo” Infectious Diseases) cohort were submitted to lateral spine X‐ray and DXA. AAC was identified using the AAC‐8 score, which estimates the total length of calcification of the anterior and posterior aortic walls in front of vertebrae L1–L4. Low BMD was defined by T‐score or Z‐score <−1 at lumbar spine or femoral neck. VF were identified by morph‐metric analysis of X‐ray and were defined by the “spine deformity index” (SDI) ≥1 according to semiquantitative method by Genant. Associations between AAC, BMD and SDI were evaluated by univariate and multivariate logistic regression models. The relationship between the grade of AAC and SDI was evaluated by Spearman's correlation.ResultsAAC≥1 was present in 65 patients (23.2%); of these 15 patients showed moderate/severe calcifications (AAC>2). Low BMD was found in 163 patients (58.2%) and VF (SDI≥1) in 47/274 patients (17.1%). By univariate analysis, factors associated with AAC>=1 were: age (for additional 10 years older HR 3.81 [IC95% 2.64–5.51], p<0.0001) lower CD4 nadir (for additional 50 CD4 HR 0.89 [IC95% 0.82–0.97], p=0.01) AIDS‐diagnosis (HR 2.13 [IC95 % 1.11–4.08], p=0.02) and being on HAART (HR 2.75 [IC95% 1.28–5.90], p=0.009). In multivariate analysis, only age (OR 2.62, IC95% 1.72–3.99, p<0.0001) resulted significantly associated with AAC≥1. Patients with AAC≥1 had twofold increase in the risk of low BMD (HR 2.45 [IC95% 1.32–4.45], p=0.004) and VF (SDI>=1: HR 2.17 [IC95% 1.1–4.2], p=0.02) compared to patients without AAC. The grade of AAC was directly correlated with the grade of SDI (rho=0.16; p=0.008): AAC>2 determines a sixfold increase in the risk of VF (HR 6.44 [IC95% 2.21–18.79], p=0.0006). AAC≥1 predict VF independently from BMD, vitamin D status and bone turnover marker (Table 1).ConclusionsIn our HIV population, AAC resulted a strong predictor of both low BMD and VF, irrespective of factors involved in bone formation. The grade of AAC was directly correlated with the grade of VF.

INTRODUCTION:We discuss asymptomatic colonic pneumatosis, an unexpected finding of computed tomography colonography that we must see as distinct from perforation. Among the papers detailing complications with computed tomography colonography, we found only one report focusing on linear pneumatosis.CASE PRESENTATION:We report the case of a 75-year-old Caucasian woman who had a high level of carcinoembryonic antigen, and who underwent computed tomography colonography. Our patient accidentally fell from a chair in the radiology department just before the examination, experiencing a right hip trauma. The examination was negative for colonic lesions but revealed the presence of some air bubbles in her right colon. Our patient remained asymptomatic throughout the procedure and afterwards; no intervention or treatment was necessary.CONCLUSION:Radiologists should consider colonic linear pneumatosis among the potential complications of computed tomography colonography, even if it is a rare event, to avoid unnecessary therapy and anxiety for the patient.

To evaluate the impact of contrast-enhanced computed tomography colonography (CE-CTC) on laparoscopic surgery planning in patient with stenosing colorectal cancer.

Rationale and Objectives: To predict the T stage of nonrectal colon cancer using contrast-enhanced computed tomography colonography.Materials and Methods: Sixty-one patients with 67 nonrectal colon cancers consecutively underwent contrast-enhanced computed tomography colonography after an incomplete colonoscopy. Two readers evaluated wall deformity and perilesional fat abnormality on three-dimensional double contrast enema-like views and multiplanar reconstructions. Pathology was used as the standard of reference. McNemar, Fisher, and Cohen kappa statistics were used.Results: At pathologic examination, we found the following stages: T1 (n = 5), T2 (n = 10), T3 (n = 41), T4a (n = 6), and T4b (n = 5). Intraobserver and interobserver reproducibilities were almost perfect for wall deformity (kappa = 1.00 and kappa = 0.88, respectively), substantial for perilesional fat abnormality (kappa = 0.79 and kappa = 0.74, respectively). Using the results of the more experienced reader, accuracy of wall deformity >= 50% (apple-core) alone for T >= 3 was 62 of 67 (0.93, 95% confidence interval [CI] 0.83-0.97) and that of perilesional fat abnormality alone was 37 of 67 (0.55, 95% CI 0.43-0.67) (P < .001). Predictive value for >= T3 of the association wall deformity >= 50% with perilesional fat abnormality was 22 of 22 (1.00, 95% CI 0.85-1.00), higher, but not significantly, than that of wall deformity >= 50% with normal perilesional fat 29 of 33 (0.88, 95% Cl 0.72-0.97) (P = .148, Fisher exact test).Conclusions: The presence of apple-core wall deformity, regardless of perilesional fat abnormality, is highly predictive of stage T3 or higher.