Role of CT Colonographyin the Evaluation of Colorectal Carcinoma

Abstract

Background: Colorectal carcinoma is one of the commonest diseases in the adult. The advancement in the technology of CT scan has offered CT colonography which explores the colonic luminal pathology. The present study is done to evaluate the role of CT colonography in colorectal carcinoma. Subjects and Methods: The prospective study was carried out in the Department of Radiodiagnosis and Imaging, Sir Sunderlal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi, over a period of 24 months. A total of 162 patients with colorectal carcinoma were selected and the disease characterization was studied using CT colonography. CT was carried out with GE (General Electric) Light speed VCT 64 slice MDCT machine. Results:The study group comprises of 106 male and 56 female patients. Highest numbers of cases (25%) were in the 6th decade of life. The commonest presenting complaints were bleeding per rectum and constipation. The rectum being the most frequently involved colonic segment in 38% of cases. Focal, asymmetric, marked (>2 cm) wall thickening of colon with heterogeneous (mixed) attenuation pattern was seen commonly. Majority of the cases presented with periserosal fat invasion and internal iliac nodal group involvement. Liver is the commonest organ for distant metastasis. Four cases of malignant solitary sigmoid colon polyps and two cases of malignant rectal polyps were also identified. Conclusion: CT colonography is effective in characterisation of the malignant colorectal growth and identifying adenomatous polyps thus can be effectively used for the early detection, staging and screening of colorectal malignancy.