Vascular Virtual Endoluminal Visualization of Invasive Colorectal Cancer on MDCT Colonography
Gen Iinuma1,
Noriyuki Moriyama1,
Mitsuo Satake2,
Kunihisa Miyakawa2,
Ukihide Tateishi2,
Nachiko Uchiyama1,
Takayuki Akasu3,
Takahiro Fujii4 and
Toshiaki Kobayashi5
1 Cancer Screening Division, Research Center for Cancer Prevention and
Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045,
Japan.
2 Diagnostic Radiology Division, National Cancer Center Hospital, Chuo-ku,
Tokyo, Japan.
3 Colorectal Surgery Division, National Cancer Center Hospital, Chuo-ku, Tokyo,
Japan.
4 Endoscopy Division, National Cancer Center Hospital, Chuo-ku, Tokyo,
Japan.
5 Cancer Screening Technology Division, Research Center Cancer for Prevention
and Screening, National Cancer Center, Chuo-ku, Tokyo, Japan.
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Fig. 1A. —Colonoscopic view and surface and vascular virtual
endoluminal images for representative case of advanced colorectal cancer in
60-year-old woman. Colonoscopic view shows advanced cancer in sigmoid
colon.
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Fig. 1B. —Colonoscopic view and surface and vascular virtual
endoluminal images for representative case of advanced colorectal cancer in
60-year-old woman. Surface virtual endoluminal image shows lesion.
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Fig. 1C. —Colonoscopic view and surface and vascular virtual
endoluminal images for representative case of advanced colorectal cancer in
60-year-old woman. Vascular virtual endoluminal image clearly shows blood
pooling of tumor and vessels (arrow) in colorectal wall.
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Fig. 2A. —64-year-old man with colorectal cancer who underwent MDCT
after colonoscopy. Colonoscopic view shows small sessile lesion with central
depression in lower rectum.
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Fig. 2B. —64-year-old man with colorectal cancer who underwent MDCT
after colonoscopy. Surface virtual endoluminal image clearly shows lesion,
although it is less than 2 cm in diameter.
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Fig. 2C. —64-year-old man with colorectal cancer who underwent MDCT
after colonoscopy. Vascular virtual endoluminal image dramatically shows blood
pooling of lesion in colorectal wall.
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Fig. 2D. —64-year-old man with colorectal cancer who underwent MDCT
after colonoscopy. Axial MDCT image also shows lesion (arrow) as
polypoid mass in insufflated rectum.
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Fig. 3A. —50-year-old man with colorectal cancer who underwent MDCT
after colonoscopy. Colonoscopic view shows irregularly shaped sessile lesion
with central ulceration in lower rectum.
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Fig. 3B. —50-year-old man with colorectal cancer who underwent MDCT
after colonoscopy. Surface virtual endoluminal image shows polypoid
lesion.
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Fig. 3C. —50-year-old man with colorectal cancer who underwent MDCT
after colonoscopy. Vascular virtual endoluminal image clearly depicts blood
pooling and small vessels (arrows) in colorectal wall.
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Fig. 3D. —50-year-old man with colorectal cancer who underwent MDCT
after colonoscopy. Axial MDCT image shows lesion (arrow) as enhanced
mass in wall.
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Fig. 4A. —59-year-old man with colorectal cancer who underwent MDCT
without preparation. Colonoscopic view shows nodular protrusion in lower
rectum.
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Fig. 4B. —59-year-old man with colorectal cancer who underwent MDCT
without preparation. It is hard to recognize lesion in residual stool
(arrows) on surface virtual endoluminal image.
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Fig. 4C. —59-year-old man with colorectal cancer who underwent MDCT
without preparation. Vascular virtual endoluminal image successfully shows
lesion as mass having blood pooling in colorectal wall.
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Fig. 4D. —59-year-old man with colorectal cancer who underwent MDCT
without preparation. Axial MDCT image shows lesion (arrow) as
enhanced mass in colorectal wall.
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Fig. 5A. —63-year-old man with colorectal cancer who underwent MDCT
without preparation. Colonoscopic view shows large mass with central
ulceration in upper rectum.
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Fig. 5B. —63-year-old man with colorectal cancer who underwent MDCT
without preparation. Because of stool material, lesion cannot be identified on
surface virtual endoluminal image.
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Fig. 5C. —63-year-old man with colorectal cancer who underwent MDCT
without preparation. Vascular virtual endoluminal image dramatically
distinguishes lesion from stool.
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Fig. 5D. —63-year-old man with colorectal cancer who underwent MDCT
without preparation. Axial MDCT image shows lesion (arrow) as
irregular thickening of rectal wall.
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Copyright © 2005 by the American Roentgen Ray Society.
