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 in Banha
Gastroenterology unit. They were ten (10) males and eight
(8) females with age ranging form 19-41 years; mean age
(28.1±II.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
done 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
for 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. |
