Editorial Reviews. Review. Master virtual colonoscopy. About the Author. University of Wisconsin School of Medicine and Public Health Madison, WI USA. Request PDF on ResearchGate | On May 1, , Ged R. Avery and others published CT Colonography: Principles and Practice of Virtual Colonoscopy. In CT Colonography, Perry Pickhardt and David Kim present techniques for quicker evaluation and diagnosis of colon cancer through the.

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When advanced or thrombosed, internal hemorrhoids may appear polypoid or mass-like at CTC Fig.

Detection of flat lesions in the colon with CT colonography. The study is generally performed on older adults and excludes most of the chest. Fortunately, the built-in redundancy of 2D and 3D CTC interpretation allows for ample opportunity for accurate lesion detection in most cases.

Abundantly illustrated in full color, this pioneering book describes CT colonography from pathogenesis, staging and treatment through indications, technique, and interpretation for the most common pathologies. A useful tool for increasing polyp specificity and decreasing interpretation time. The same cannot be said for luminal examinations like BE and OC. Item s unavailable for purchase. CT colonography virtual colonoscopy: A number of important artifacts result from post-processing of the MDCT source data.

Given its polypoid or mass-like appearance, confident assessment of the ileocecal valve at CTC seems to be an initial concern for many novice readers. As part of our general intake form, we obtain a surgical history on all patients when scheduling the CTC examination.

Robust preparation, distention, scanning, and interpretation techniques will greatly minimize or avoid many pitfalls at CTC. Tagging-based, electronically cleansed CT colonography: Interpretive pitfalls at CTC can be divided in those related to technique and those related to anatomic considerations, although considerable overlap exists.


American Journal of Gastroenterology. Please review our privacy policy. Care must be taken in such cases to ensure a true flat soft tissue polyp does not lie deep to the contrast.

In our experience, a false positive interpretation due to residual stool is extremely rare when using our dedicated cathartic preparation with the dual contrast tagging regimen. The mass was confirmed at OC E but endoscopic biopsies were inconclusive. Positive predictive value for polyps detected at screening CT colonography. Recognition and understanding of the major interpretive pitfalls are the most important steps in avoiding many of them.

PickhardtDavid H. On 2D, contrast coating of polyps is easy to distinguish from internal tagging prqctice stool, which colpnography a critical distinction. Note that the adherent stool is nondependent on this prone 2D view, which could simulate a true lesion if untagged.

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Findings on optical colonoscopy after positive CT colonography exam. From these pathologic features, and combined with its high prevalence, diverticular disease not surprisingly represents the leading cause of nondiagnostic segmental evaluation at CTC.

Decubitus positioning B and increase to 25 mm Hg resulted in good luminal distention of this segment, as shown by frontal C and lateral D 3D colon maps. Optical colonoscopy versus CT colonography with pig colonic specimens.

In the future, a better approach might be to give diatrizoate as part of the original OC preparation, which would allow for a reduction in the amount of cathartic needed and also provide fluid tagging for CTC in the event of an incomplete OC examination. Focal abnormalities arrows were also noted at prachice ileocecal valve F and G and the appendiceal orifice F and H.


The prone images colnooscopy a similar appearance not shown. Some CTC protocols target more aggressive dose reduction on the prone view since much of the information is redundant to the supine view. Clinical Gastrointestinal Endoscopy E-Book. Polyp measurement on the 3D endoluminal view can also be problematic if care is not taken to optimize the vantage point. Furthermore, the inherent characteristics of the colon wall-air interface allow for substantial dose reduction at CTC compared with standard abdominal CT imaging.

A variety of other anorectal pathology is much less commonly encountered. Interventional Cardiology, Second Edition. Essentials of Regional Anesthesia.

CT Colonography: Pitfalls in Interpretation

Supine transverse 2D A and B and 3D endoluminal C CTC images show a large flat soft tissue mass arrowheads opposite the ileocecal valve arrow that has a somewhat lobulated appearance and results in fold distortion on 3D.

Surgery is indicated for appendiceal mucoceles since almost all lesions are neoplastic and mucinous and are considered at least potentially malignant. Both 3D translucency rendering B and 2D correlation C show dense internal contrast tagging, easily excluding a polyp.

These non-neoplastic lesions can be difficult to differentiate from neoplastic disease. Transverse 2D CTC images with polyp Przctice and soft tissue B window settings show a multi-lobulated mass occupying the expected location of the ileocecal valve.

Spectrum of normal findings, anatomic variants and pathology of ileocecal valve: See if you have enough points for this item.