Virtual colonoscopy as a new diagnostic tool in cancer colon

Virtual reality imaging is a new technology that combines helical computed tomography and magnetic resonance [MR] data and advanced three-dimensional graphics software to generate endoluminal perspective images of hollow organs. Computed tomography colonography [Virtual colonoscopy] is an imaging procedure in which a series of helical CT scans of the patient's colon are rendered by computer into slices that can be visualized as serially combined images to provide a three-dimentional tour of the colon. So, this technique has been evaluated, mostly conducted in diagnostic [rather than screening] setting in higher-risk patients. In this work, we try to evaluate the sensitivity and accuracy of virtual colonoscopy as a new modality for colorectal evaluation in patients subjected to traditional colonoscopy and double-contrast barium enema study who are diagnosed as having cancer colon and to correlate the findings of virtual colonoscopy with those of conventional colonoscopy and barium study. This work was conducted on twenty [20] patients, selected among 91 patients of different colonic illness admitted in Mansoura and Banha Gastroenterology Centers. They were thirteen [13] males and seven [7] females with age ranging form 49-75 years; mean age [59.5 +/- 8.6] years. All patients were subjected to complete medical history, thorough clinical examination, routine laboratory tests and special laboratory investigations as carcino-embryonic antigen [CEA] and occult blood in stool. Abdominal ultrasonography, barium double-contrast enema, traditional colonoscopy and virtual colonoscopy were done for all patients. Colonoscopic biopsies were obtained as routine in every case in addition to biopsy from any suspected areas or detected masses. Histopathological examination was done also for every sample. From this study, we concluded that CT colonography [Virtual Colonoscopy] is feasible for the detection of colorectal cancer with high success in sizes more than 10mm and further technical advances will improve the performance of CT colonoscopy and will allow patients available imaging modality for full structural examination of the colon

Virtual colonoscopy in ulcerative colitis: a comparative study

Ulcerative colitis [UC] is an inflammatory disease of the colon and rectum. Many investigations are put for diagnosis and follow up of its course and complications. Virtual reality imaging is a new technology that combines helical computed tomography, magnetic resonance [MR] data and advanced three-dimensional graphics software to generate endoluminal perspective images of hollow organs.Computed tomography colonography [Virtual colonoscopy] is an imaging procedure in which a series of helical CT scans of the patient's colon are rendered by computer into slices that can be visualized as serially combined images to provide a three-dimensional tour of the colon. In this work, we try to evaluate the sensitivity and accuracy of virtual colonoscopy as a new modality for colorectal evaluation in patients who had been subjected to traditional colonoscopy and double-contrast barium enema study and who were diagnosed as having a chronic intermittent ulcerative colitis disease and to correlate the findings of virtual colonoscopy with those of conventional colonoscopy and barium study. This work was conducted on eighteen [18] patients admitted to Banha Gastroenterology unit. They were ten [10] males and eight [8] females with age ranging form 19-41 years; mean age [28.1 +/- 11.5] years. All patients were subjected to complete medical history, thorough clinical examination, routine laboratory tests and special laboratory investigations as carcinoembryonic antigen [CEA] and occult blood in stool. Abdominal ultrasonography, barium double-contrast enema, traditional colonoscopy and virtual colonoscopy were clone for all patients. Colonoscopic biopsies were obtained as a routine in every case. In our study, traditional colonoscopy gave positive data in 100.0%, while virtual colonoscopy gave positive results in 61.1% and barium enema gave positivity in 55.6%. Characteristic features of ulcerative colitis were evident on the 2-D images and the 3-D endoluminal and extraluminal images obtained by virtual colonoscope. From this study, we concluded that CT colonography [Virtual Colonoscopy] is a non invasive procedure feasible lor follow up of ulcerative colitis and could be used to monitor the extent of intestinal inflammations as well as possible complications such as malignant changes, strictures or stenosis in most patients. Further technical advances will improve the performance of CT colonoscopy and will allow patients available imaging modality for full structural changes of the colon

Computed tomography and MRI evaluation of mucoceles of the paranasal sinuses with reference to intracranial and extracranial extensions

15 patients with mucoceles of the paranasal sinuses were studied, the commonest sinus to be involved was the ethmoid followed by the frontal maxillary and spheno-ethmoidal, while sphenoid sinus alone was not involved. All the cases were subjected to computed tomography and only 2 cases were examined by magnetic resonance imaging. CT was usually sufficient for making diagnosis and defining the extent of the lesion, accurately demonstrating the orbital and intracranial extensions by both axial and coronal sections. All cases were explored surgically verifying the extension and the chronicity. MRI was very valuable in detecting the nature of the mucocele by high T2-Wls, while Tl-Wls differed according to the chronicity of the mucocele also MRI by its multiplanner capability demonstrated the extent of the lesion. One drawback of the MRI was its poor demonstration of the bones and calcifications of the sinuses, while high resolution CT demonstrated bone details and intracranial extension better. T2-weighted image and it displays the sinus in 3 plane imaging with direct sagittal sections