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Congress: ECR26
Poster Number: C-10572
Type: Poster: EPOS Radiographer (scientific)
Authorblock: Y. Ohashi, K. Harada, T. Tanaka, S. Hayasaka, K. Ishibashi, R. Kasahara, N. Yama; Sapporo/JP
Disclosures:
Yoshiya Ohashi: Nothing to disclose
Kohei Harada: Nothing to disclose
Takeo Tanaka: Nothing to disclose
Shun Hayasaka: Nothing to disclose
Kizuku Ishibashi: Nothing to disclose
Ryo Kasahara: Nothing to disclose
Naoya Yama: Nothing to disclose
Keywords: Colon, Vascular, Veins / Vena cava, CT, CT-Angiography, CT-Colonography, Colonography CT, Contrast agent-intravenous, Physics, Biological effects, Cancer, Inflammation
Purpose Contrast-enhanced CT colonography (CTC) is commonly used for preoperative evaluation of colorectal cancer, enabling assessment of tumor morphology together with mesenteric vascular anatomy. High-quality visualization of the mesenteric veins, particularly the inferior mesenteric vein (IMV) and superior mesenteric vein (SMV), is clinically valuable for precise preoperative vascular mapping and for assessing extramural venous invasion (EMVI) in colon cancer, an important prognostic indicator of tumor spread [1–3]. Accurate evaluation of these factors contributes to optimal surgical planning and reduces the risk...
Read more Methods and materials Study Design and PopulationThis retrospective study included 170 patients who underwent preoperative contrast-enhanced CT between April 2017 and October 2021. Patients with bowel obstruction, inflammatory disease, or collateral venous pathways were excluded. The final cohort was divided into two groups: CO₂ insufflation group: n = 86. Non-insufflation group: n = 84. [fig 4]  CT Acquisition ProtocolPortal venous phase imaging was performed at fixed delays of 25, 30, or 35 seconds after initiation of arterial-phase scanning. Attenuation values (HU) of the IMV and SMV were measured...
Read more Results Patient Characteristics A total of 170 patients (mean age, 66.6 ± 13.0 years; 72 males and 98 females) were included. No significant differences were observed between groups in demographic characteristics or contrast injection parameters. Within the CO₂ insufflation group, colonic gas volume did not differ significantly among scan-delay subgroups.  IMV Enhancement The IMV demonstrated a clear shift in enhancement timing depending on CO₂ insufflation.CO₂ insufflation group The highest IMV attenuation was observed at a 25-second delay (283.0 ± 40.4 HU). Attenuation decreased significantly...
Read more Conclusion CO₂ insufflation during CT colonography is associated with earlier and stronger mesenteric venous enhancement, particularly in the IMV. Early scanning combined with careful control of insufflation volume optimizes vascular visualization and may enhance the diagnostic and preoperative utility of CT colonography.
Read more Personal information Yoshiya Ohashi, RTDivision of Radiology & Nuclear Medicine Sapporo Medical University Hospital, Japan
Read more References Ogino T, Takemasa I, Horitsugi G, Furuyashiki M, Ohta K, Uemura M, Nishimura J, Hata T, Mizushima T, Yamamoto H, Doki Y, Mori M (2014) Preoperative evaluation of venous anatomy in laparoscopic complete mesocolic excision for right colon cancer. Ann Surg Oncol 21 Suppl 3:S429-S435. https://doi.org/10.1245/s10434-014-3572-2 Peltrini R, Luglio G, Pagano G, Sacco M, Sollazzo V, Bucci L (2019) Gastrocolic trunk of Henle and its variants: review of the literature and clinical relevance in colectomy for right-sided colon cancer. Surg Radiol...
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