CT colonography

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Author: Mikael Häggström [notes 1]

CT colonography of a rectal mass. Left image is a volume rendering and right image is a thin slice. It also shows the rectal tube used for insufflation of gas to distend the colon.

Contents

Planning

Choice of modality in suspected colon cancer

  • Colonoscopy is generally the first investigation of choice
  • CT colonography is the investigation of choice in case colonoscopy is unfeasible or has been performed with incomplete examination. Such potential causes include patient discomfort or intolerance to the colonoscopy, looping of the scope, redundant colon, colonic spasm, acute angle flexures and tortuosity, and colonic obstruction caused by a tumor or adherences from previous surgery.[1]

Settings

Generally:

  • Bowel preparation with laxative
  • Air (such as CO2) insufflation. For patients with a hernia large enough to constitute a risk for incarceration of the colon, attending personnel need to be prepared to abort the insufflation in case the patient develops pain that is unusually severe during the procedure.
  • Non-contrast image in prone position, and contrast CT in supine position in venous phase.

Evaluation

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.

References

  1. Scalise, Paola; Mantarro, Annalisa; Pancrazi, Francesca; Neri, Emanuele (2016). "Computed tomography colonography for the practicing radiologist: A review of current recommendations on methodology and clinical indications ". World Journal of Radiology 8 (5): 472. doi:10.4329/wjr.v8.i5.472. ISSN 1949-8470.