Role of Enhanced CT Combined with CT Virtual colonoscopy Compared to Colonic Endoscopy in Detection of Colorectal Pathology

Aggour, Dalia Ibrahim; Alwarraky, Mohamed Shawky; Barseem, Esraa Metwaly; Zaghla, Hassan Alsayed; Gomae, Manal Ibrahim

doi:10.21608/ijma.2025.351481.2100

Role of Enhanced CT Combined with CT Virtual colonoscopy Compared to Colonic Endoscopy in Detection of Colorectal Pathology

Document Type : Original Article

Authors

¹ Diagnostic and Intervention Radiology medical imaging Department, National Liver institute, Shebin Elkom, Menoufia

² Hepatolgy and Gastroenterology, National Liver Institute, Shebin Elkom, Menoufia, Egypt

10.21608/ijma.2025.351481.2100

Abstract

Background: Colorectal pathology is the study of diseases affecting the colon, rectum, and anus, encompassing a range of conditions from benign to malignant. It includes common disorders such as polyps, inflammatory bowel disease [IBD], diverticulosis, and colorectal cancer. The aim of this study was to assess Clinical Value of Enhanced computed tomography [CT] Combined with CT Virtual colonoscopy compared to colonic endoscopy in detection of colorectal pathology.
Methods: This prospective study included 30 patients at the National Liver Institute, Menoufia, Egypt.
Results: Our study showed excellent agreement between computed tomography colonography [CTC] and conventional colonoscopy [kappa = 0.792, P < 0.001], with CTC demonstrating high sensitivity [95.83%] and specificity [83.33%]. CTC detected a slightly higher number of pathologies, identifying 40.0% of masses or suspicious thickening compared to colonoscopy's 33.33%. For IBD, CTC identified 26.66% of cases, marginally surpassing colonoscopy's 23.33%, and both methods equally detected diverticulosis in 13.33% of cases. CTC achieved 100.0% accuracy for rectosigmoid and sigmoid lesions, and 96.67% accuracy across other locations, with minor discrepancies overall. Additionally, CTC had a lower complication rate, with fewer patients experiencing abdominal distension [16.66%] compared to conventional colonoscopy [36.67%].
Conclusion: The strong performance of Enhanced CT Combined with CT Virtual colonoscopy in this study, particularly its high sensitivity and specificity, suggests it could be a valuable tool in colorectal pathology detection, offering a less invasive alternative with fewer complications compared to conventional colonoscopy.

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