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<p>To evaluate whether carbon dioxide (CO₂) insufflation modifies the relationship between scan delay and mesenteric venous attenuation during fixed-delay portal venous phase scans in contrast-enhanced CT colonography (CTC). This retrospective study included 170 patients (mean age, 66.6 ± 13.0 years; 72 men) who underwent contrast-enhanced abdominal CT between April 2017 and October 2021 with portal venous phase scans acquired at fixed delays of 25, 30, or 35&#xa0;s after the start of arterial-phase scanning. Examinations were classified as the CO₂ insufflation group (<i>n</i> = 86) or the non-insufflation group (<i>n</i> = 84). Attenuation of the inferior and superior mesenteric veins (IMV, SMV) was measured at each delay. Associations among insufflation status, scan delay, and venous attenuation were evaluated using multivariable linear regression including a CO₂-by-delay interaction term. In the CO₂ insufflation group, IMV attenuation was highest at 25&#xa0;s (283.0 ± 40.4 HU) and decreased at 30–35&#xa0;s (<i>p</i> &lt; 0.001), whereas in the non-insufflation group IMV attenuation was higher at 30–35&#xa0;s than at 25&#xa0;s (<i>p</i> = 0.002). SMV attenuation showed a similar directional pattern with smaller magnitude. Significant CO₂-by-delay interactions were observed for both veins (<i>p</i> &lt; 0.05), indicating different delay–attenuation relationships by insufflation status. In routine fixed-delay CTC, CO₂ insufflation was associated with a modified relationship between scan delay and mesenteric venous attenuation, most prominently in the IMV. Mesenteric venous enhancement on portal venous phase scans should be interpreted in the context of insufflation status.</p>

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Effect of carbon dioxide insufflation on the delay–attenuation relationship of mesenteric veins in contrast-enhanced CT colonography

  • 期刊论文

  • 发表日期：

    2026年4月13日

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  • Yoshiya Ohashi,
  • Kohei Harada,
  • Takeo Tanaka,
  • Shun Hayasaka,
  • Kizuku Ishibashi,
  • Ryo Kasahara,
  • Naoya Yama

摘要

To evaluate whether carbon dioxide (CO₂) insufflation modifies the relationship between scan delay and mesenteric venous attenuation during fixed-delay portal venous phase scans in contrast-enhanced CT colonography (CTC). This retrospective study included 170 patients (mean age, 66.6 ± 13.0 years; 72 men) who underwent contrast-enhanced abdominal CT between April 2017 and October 2021 with portal venous phase scans acquired at fixed delays of 25, 30, or 35 s after the start of arterial-phase scanning. Examinations were classified as the CO₂ insufflation group (n = 86) or the non-insufflation group (n = 84). Attenuation of the inferior and superior mesenteric veins (IMV, SMV) was measured at each delay. Associations among insufflation status, scan delay, and venous attenuation were evaluated using multivariable linear regression including a CO₂-by-delay interaction term. In the CO₂ insufflation group, IMV attenuation was highest at 25 s (283.0 ± 40.4 HU) and decreased at 30–35 s (p < 0.001), whereas in the non-insufflation group IMV attenuation was higher at 30–35 s than at 25 s (p = 0.002). SMV attenuation showed a similar directional pattern with smaller magnitude. Significant CO₂-by-delay interactions were observed for both veins (p < 0.05), indicating different delay–attenuation relationships by insufflation status. In routine fixed-delay CTC, CO₂ insufflation was associated with a modified relationship between scan delay and mesenteric venous attenuation, most prominently in the IMV. Mesenteric venous enhancement on portal venous phase scans should be interpreted in the context of insufflation status.