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Automated Carbon Dioxide Insufflation for CT Colonography: Effectiveness of Colonic Distention in Cancer Patients with Severe Luminal Narrowing

So Yeon Kim1, Seong Ho Park1, Eugene K. Choi2, Seung Soo Lee1, Kyoung Ho Lee3, Jin Cheon Kim1, Chang Sik Yu1, Hee Cheol Kim1, Ah Young Kim1 and Hyun Kwon Ha1

1 Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-Dong, Songpa-Gu, 138-040 Seoul, Korea.
2 Weill Medical College of Cornell University, New York, NY.
3 Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Korea.


Figure 1
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  		Fig. 1 —Flow diagram of study subjects. CTC = CT colonography.

 

Figure 2
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  		Fig. 2A —CT colonography images show different grades of colonic distention. Grade 1 distention of descending colon in 32-year-old woman: Colon (arrows) is completely collapsed and has no identifiable lumen.

 

Figure 3
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  		Fig. 2B —CT colonography images show different grades of colonic distention. Grade 2 distention of sigmoid colon in 68-year-old man: Colon is partially collapsed. Note absence of a clear central path to navigate owing to meeting of thickened haustral folds (arrows) within colonic lumen.

 

Figure 4
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  		Fig. 2C —CT colonography images show different grades of colonic distention. Grade 3 distention of descending colon in 50-year-old man: Colon is reasonably but suboptimally distended. Colonic wall (arrows) is easily visible, but there is clear central pathway through segment.

 

Figure 5
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  		Fig. 2D —CT colonography images show different grades of colonic distention. Grade 4 distention of transverse colon in 50-year-old man: Colon is optimally distended. Note that colonic wall (arrows) is barely visible.

 

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