TECHNICAL REPORT - SPIRAL CT PNEUMOCOLON FOR SUSPECTED COLONIC NEOPLASMS

Abdominal spiral computed tomography (CT) pneumocolon is performed aft er cleansing the colon, using a smooth muscle relaxant and rectal air insufflation. Rapid dynamic scanning is undertaken with intravenous co ntrast to give optimal hepatic and vascular enhancement, and 5-10 mm c ontiguous slices. The area of interest in the colon is reconstructed e very 2.5 mm. This technique was performed in four patients with colore ctal cancer and the CT findings were compared with the barium enema an d pathology following surgical resection, Spiral CT pneumocolon clearl y showed the primary tumour in all eases as an enhancing soft tissue m ass, and,vas able to detect local extension and lymphadenopathy as wel l as assess the liver, peritoneum and remaining abdomen, CT depicted t he morphology of the primary tumour more clearly than barium enema, an d in one case also detected a 1 cm polyp which was not seen on the bar ium study because the patient was incontinent of barium and views were limited. There was good correlation between the CT and pathological f indings. Compared to a barium enema, spiral CT pneumocolon is quick, w ith minimal patient discomfort, no risk of barium incontinence, and th ere is good assessment of the local and distant abdominal disease, Mul tiplanar formatting is possible and 3-D reconstruction gives intra- an d extra-luminal views.