Patient History

A 39 year old female presented with rectal bleeding and was found to have a mass on clinical examination. A portal venous phase diagnostic scan showed a rectosigmoid tumour (Figure 1). Further polyps were also noted on this scan (Figure 2). Subsequent endoscopy and surgery confirmed an underlying diagnosis of familial adenomatous polyposis, not suspected initially, and the tumour (TNM stage - T4, N0, M0).

Procedure

A CT perfusion study was performed prior to the portal venous abdominal pelvic scan. Blood volume, blood flow, mean transit time and permeability measurements may provide information regarding biological behaviour, and may be used for monitoring treatment.

CT Perfusion Findings

Click on the images to enlarge

Figure 1.		Figure 2.
Enhanced CT showing the rectosigmoid tumour		Enhanced CT showing a rectal polyp (arrowhead)
Figure 3.
Blood volume map		Blood flow map
Mean transit time map		Permeability map

Blood volume, blood flow, mean transit time and permeability within the tumour.

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Acquisition Parameters

• Acquisition time: 60s
• Rotation speed: 1s
• Collimation: 4 x 5 mm
• Scan delay: 5 seconds
• Scanner: 4-slice LightSpeed Plus
• Tube voltage: 120 kV
• Tube current: AutoMa 80 mA
• Contrast agent: 350 Omnipaque - 100 cc at 5ml/s