Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed
CPT4 code
Name of the Procedure:
Computed Tomographic (CT) Colonography, Diagnostic, with Contrast Material(s) including Non-Contrast Images (if performed)
Summary
CT colonography, also known as a virtual colonoscopy, is a minimally invasive imaging procedure that uses CT scanning to obtain an interior view of the colon (large intestine). It includes both contrast-enhanced and non-contrast images to help diagnose various conditions.
Purpose
This procedure is primarily used to detect abnormalities in the colon such as polyps, cancer, diverticula, and inflammatory bowel disease. The goal is to provide a detailed and comprehensive view of the colon without the need for traditional endoscopic techniques.
Indications
- Symptoms such as unexplained abdominal pain, rectal bleeding, or chronic diarrhea.
- Screening for colorectal cancer, particularly in individuals over 50 or those with a family history of the disease.
- Follow-up evaluations for patients who have had polyps previously removed or have inflammatory bowel disease.
Preparation
- Patients are typically required to follow a special diet and take bowel-cleansing laxatives the day before the procedure.
- Fasting may be required for several hours prior to the procedure.
- Patients should inform their healthcare provider about any medications they are taking and may need to adjust or temporarily discontinue certain medications.
Procedure Description
- The patient changes into a hospital gown and lies on the CT scanning table.
- A small, flexible tube is inserted into the rectum to gently inflate the colon with air or carbon dioxide, enhancing the visibility of the colon walls.
- The CT scanner captures images of the colon, first without contrast material and then with a contrast material injected intravenously.
- The images are processed to create detailed, 3D models of the colon for evaluation by a radiologist.
Duration
The entire procedure typically takes around 30 to 60 minutes, including preparation and image acquisition.
Setting
CT colonography is usually performed in a hospital radiology department or an outpatient imaging center.
Personnel
- Radiologist: Interprets the images
- Radiologic Technologist: Operates the CT scanner and assists with the procedure
- Nursing staff may also be involved for patient preparation and recovery
Risks and Complications
- Exposure to a small amount of ionizing radiation
- Potential allergic reaction to the contrast material
- Discomfort or cramping from colon inflation
- Rare risks include bowel perforation
Benefits
- Non-invasive with no need for sedation
- High accuracy in detecting polyps and cancers
- Quick recovery and minimal post-procedure downtime
Recovery
- Patients can usually resume normal activities immediately after the procedure.
- Drinking plenty of fluids to help flush the contrast material from the body is recommended.
- Follow-up appointments will be scheduled based on the findings.
Alternatives
- Traditional colonoscopy: more invasive, but allows for polyp removal during the procedure
- Flexible sigmoidoscopy: examines only the lower part of the colon
- Stool-based tests: non-invasive, but less detailed
Patient Experience
- Some discomfort from the insertion of the rectal tube and colon inflation
- Typically no pain during the imaging
- Mild cramping or bloating may occur after the procedure, but should resolve quickly
- Detailed care instructions and pain management options will be provided to ensure patient comfort.