CT colonography (virtual colonoscopy): Technique, indications and performance

Hebrew University of Jerusalem, Yerushalayim, Jerusalem, Israel
Digestion (Impact Factor: 2.03). 02/2007; 76(1):34-41. DOI: 10.1159/000108392
Source: PubMed

ABSTRACT Worldwide, colorectal cancer is the third most frequent cancer occurring in both sexes. Screening programs for early detection enable detection of tumors at an earlier stage and have been shown to reduce death rate. Currently, colonoscopy is the investigation of choice for colorectal cancer screening and for investigation of patients with suspected colorectal cancer. However, colonoscopy remains an invasive technique requiring anesthesia, with a risk of perforation and bleeding. In addition, even experienced colonoscopists may be unable to complete the colonoscopy due to multiple reasons such as severe diverticulosis, stricture, obstructing mass, or fixation of colonic loops. CT colonography, also known as virtual colonoscopy, is a relatively new technique that is becoming increasingly popular. The technical aspects, indications, advantages and diagnostic performance of this technique are briefly reviewed.

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    ABSTRACT: Computed tomography colonography, or virtual colonoscopy, is a good alternative to optical colonoscopy. However, suboptimal patient preparation or colon distension may reduce the diagnostic accuracy of this imaging technique. We report the case of an 83-year-old Caucasian woman who presented with a five-month history of pneumaturia and fecaluria and an acute episode of macrohematuria, leading to a high clinical suspicion of a colovesical fistula. The fistula was confirmed by standard contrast-enhanced computed tomography. Optical colonoscopy was performed to exclude the presence of an underlying colonic neoplasm. Since optical colonoscopy was incomplete, computed tomography colonography was performed, but also failed due to inadequate colon distension. The insufflated air directly accumulated within the bladder via the large fistula. Clinicians should consider colovesical fistula as a potential reason for computed tomography colonography failure.
    Journal of Medical Case Reports 07/2012; 6(1):214. DOI:10.1186/1752-1947-6-214


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