RadioGraphics, Vol 6, 213-244, Copyright © 1986 by Radiological Society of North America
Direct coronal and direct sagittal CT of abdomen and pelvis: an approach to staging malignancies
PF van Waes, MA Feldberg, HI Goldberg, P Herve, FW Zonneveld and CE Cann
Department of Radiagnosis, University Hospital Utrecht, The Netherlands.
Direct coronal and sagittal CT images are of high quality and are
applicable to a majority of patients in daily practice. Because of the fact
that transverse scans alone can be misleading, direct CT images in two or
more different planes greatly enhance one's capability to stage neoplasms
that are complex and extensive. The integrity of the margins of an organ,
in the presence of tumor, is best determined by coronal or sagittal
scanning. Lesions of the adrenal and kidney and retroperitoneal processes
with possible extension into liver or other adjacent organs can be
evaluated best using the combination of transverse and coronal or sagittal
scans of the upper abdomen. Depending on the origin of pelvic lesions, the
radiologist must consider in every individual case the performance of
either direct coronal or sagittal sections or both. This judgment is based
on the findings on the transverse scans, understanding of anatomic
relationships of the pelvic viscera and knowledge of staging systems and
their implications with respect to therapeutic decisions. In such a
tailored approach, multiplanar CT facilitates improved presurgical
evaluation. In some cases, the true extent of the lesion can only be seen
in the coronal or sagittal planes. A potential new role for direct
multiplanar CT is that it may be used as a sort of "gold standard" for the
analysis of multiplanar ultrasound and MRI studies.
