Intravenous contrast enhancement in computed tomography of pelvic malignancies

The value of intravenous contract enhancement in computed tomography (CT) of pelvic malignancies was analyzed in 124 cases. Contrast enhancement of pelvic organs depends on the smooth muscle component and the administered iodine dose. Contrary to parenchymal organs in the abdomen the iodine washout from smooth muscle organs is slow. A rapid (approximately 5 minutes) intravenous infusion of 300 ml diatrizoate 30% followed immediately by scanning of the area of interest was found optimum to improve the CT visualization of tumors in all pelvic organs with the exception of the prostate. Depending on the organ to be investigated the intravenous contrast administration has to be combined with retrograde gas insufflation into bladder and/or rectum with insertion of a tampon into the vagina. The described technique is particularly useful for the assessment of early tumor extension beyond the primary organ.