Virtual Colonoscopy Radiology Insider

Ten years of virtual colonoscopy practice have shown that insufflation is key to success with the technique. Those who would master insufflation's intricacies might also do well to spend some time with Dr. Elizabeth McFarland and colleagues from Washington University in St. Louis.

Dear AuntMinnie Insider,

Ten years of virtual colonoscopy practice have shown that insufflation is key to successful imaging. Those who would master insufflation's intricacies might do well to spend some time with Dr. Elizabeth McFarland and colleagues from Washington University in St. Louis.

McFarland, an associate professor of radiology at the Mallinckrodt Institute, offers a powerful argument for learning a few special techniques for examining patients who are difficult to insufflate. These are often the same patients who have failed colonoscopy or even a barium enema exam, she says, and for whom virtual colonoscopy may be a last resort. Thus, a little extra time with them is time well spent, she said in a talk at the 2003 International Symposium on Virtual Colonoscopy.

For most patients, right-side-down insufflation followed by supine does the trick. Other patients do better beginning with left-side down, or even supine insufflation for those who can't deal with prone. The topogram, or scout image, is an essential guide for making insufflation work for nearly everyone, even patients who are debilitated or have tortuous colons. Get the lowdown on filling up in our Insider Exclusive story, published for Insider subscribers before it is made available for the rest of our AuntMinnie members.

While you're in the community, be sure to read our story on the use of intravenous contrast in virtual colonoscopy, based on a talk by Dr. Martina Morrin from Beth Israel Deaconess Medical Center in Boston. The preeminent authority on contrast enhancement in VC discusses the situations when contrast is the right choice in virtual colonoscopy. Find out how, why, and when, here.

Finally, we're always on the lookout for innovation in virtual colonoscopy. If you're interested in contributing an article to our Virtual Colonoscopy Digital Community, please don't hesitate to drop me a line.