Radiographics 2000 Mar-Apr;20(2):419-30
Spiral CT of colon cancer: imaging features and role in management.
Horton KM, Abrams RA, Fishman EK.
Colorectal cancer is a common malignancy that results in significant morbidity
and mortality. Abdominal computed tomography (CT) is valuable in planning
surgery for colon cancer because it can demonstrate regional extension of tumor
as well as adenopathy and distant metastases. At CT, colorectal cancer typically
appears as a discrete soft-tissue mass that narrows the colonic lumen.
Colorectal cancer can also manifest as focal colonic wall thickening and luminal
narrowing. Complications of primary colonic malignancies such as obstruction,
perforation, and fistula can be readily visualized with CT. At CT, local
extension of tumor appears as an extracolic mass or simply as thickening and
infiltration of pericolic fat. Extracolic spread is also suggested by loss of
fat planes between the colon and adjacent organs. The liver is the predominant
organ to be involved with metastases from colorectal cancer. At CT, hepatic
metastases usually appear as hypoattenuating masses, which are best visualized
during the portal venous phase of liver enhancement. Other common sites of
metastases from colon cancer include the lungs, adrenal glands, and bones. Use
of CT is critical for identifying recurrences, evaluating anatomic
relationships, documenting "normal" postoperative anatomy, and
confirming the absence of new lesions during and after therapy.
