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Positional Change in Colon Polyps at CT Colonography¹

¹ From the Department of Radiology, Division of Abdominal Imaging (S.L., M.M.), and Department of Medicine (E.J.B.), NYU Medical Center, Tisch Hospital, 560 First Ave, Suite HW 207, New York, NY 10016. Received June 12, 2003; revision requested August 26; revision received September 17; accepted October 21. Address correspondence to M.M. (e-mail: michael.macari@med.nyu.edu).

View larger version (137K): [in a new window]   Figure 1a. A 12-mm pedunculated polyp in a 67-year-old man. (a) Transverse CT image obtained in the supine position shows filling defect (arrow) on the dorsal surface of the sigmoid colon. (b) Transverse CT image obtained in the prone position shows the same filling defect (arrow) on the ventral surface of the sigmoid colon. (c) Three-dimensional endoluminal view shows stalk (arrowhead) and head (arrow) of this mobile pedunculated lesion. Endoscopy revealed a 12-mm hyperplastic polyp.

View larger version (139K): [in a new window]   Figure 1b. A 12-mm pedunculated polyp in a 67-year-old man. (a) Transverse CT image obtained in the supine position shows filling defect (arrow) on the dorsal surface of the sigmoid colon. (b) Transverse CT image obtained in the prone position shows the same filling defect (arrow) on the ventral surface of the sigmoid colon. (c) Three-dimensional endoluminal view shows stalk (arrowhead) and head (arrow) of this mobile pedunculated lesion. Endoscopy revealed a 12-mm hyperplastic polyp.

View larger version (121K): [in a new window]   Figure 1c. A 12-mm pedunculated polyp in a 67-year-old man. (a) Transverse CT image obtained in the supine position shows filling defect (arrow) on the dorsal surface of the sigmoid colon. (b) Transverse CT image obtained in the prone position shows the same filling defect (arrow) on the ventral surface of the sigmoid colon. (c) Three-dimensional endoluminal view shows stalk (arrowhead) and head (arrow) of this mobile pedunculated lesion. Endoscopy revealed a 12-mm hyperplastic polyp.

View larger version (98K): [in a new window]   Figure 2a. A 27-mm pedunculated polyp in a 58-year-old man. (a) Transverse CT image obtained in the supine position shows large filling defect (arrow) on the dorsal surface of the descending colon. (b) Transverse CT image obtained in the prone position shows the same filling defect (arrow) on the ventral surface of the descending colon. (c) Coronal view shows stalk (arrowhead) and head (arrow) of this mobile pedunculated lesion.

View larger version (96K): [in a new window]   Figure 2b. A 27-mm pedunculated polyp in a 58-year-old man. (a) Transverse CT image obtained in the supine position shows large filling defect (arrow) on the dorsal surface of the descending colon. (b) Transverse CT image obtained in the prone position shows the same filling defect (arrow) on the ventral surface of the descending colon. (c) Coronal view shows stalk (arrowhead) and head (arrow) of this mobile pedunculated lesion.

View larger version (126K): [in a new window]   Figure 2c. A 27-mm pedunculated polyp in a 58-year-old man. (a) Transverse CT image obtained in the supine position shows large filling defect (arrow) on the dorsal surface of the descending colon. (b) Transverse CT image obtained in the prone position shows the same filling defect (arrow) on the ventral surface of the descending colon. (c) Coronal view shows stalk (arrowhead) and head (arrow) of this mobile pedunculated lesion.

View larger version (145K): [in a new window]   Figure 3a. A 6-mm sessile polyp in a 69-year-old man. (a) Transverse CT image obtained in the supine position shows 6-mm lesion (arrow) on the ventral surface of the sigmoid colon. (b) Transverse CT image obtained in the prone position shows the same filling defect (arrow) on the dorsal surface of the sigmoid colon. At colonoscopy (images not shown), a 6-mm sessile tubular adenoma was identified in the sigmoid colon. In this case, the polyp is on the nondependent surface of the colon on images obtained with the patient in the supine and the prone position. This suggests that the lesion is not residual fecal material.

View larger version (149K): [in a new window]   Figure 3b. A 6-mm sessile polyp in a 69-year-old man. (a) Transverse CT image obtained in the supine position shows 6-mm lesion (arrow) on the ventral surface of the sigmoid colon. (b) Transverse CT image obtained in the prone position shows the same filling defect (arrow) on the dorsal surface of the sigmoid colon. At colonoscopy (images not shown), a 6-mm sessile tubular adenoma was identified in the sigmoid colon. In this case, the polyp is on the nondependent surface of the colon on images obtained with the patient in the supine and the prone position. This suggests that the lesion is not residual fecal material.

View larger version (126K): [in a new window]   Figure 4a. An 11-mm sessile polyp in a 65-year-old man. (a) Transverse CT image obtained in the supine position shows an 11-mm lesion (arrow) on the dorsal surface of the cecum. (b) Transverse CT image obtained in the prone position shows the same filling defect (arrow) on the ventral surface of the cecum. At colonoscopy (images not shown), an 11-mm sessile tubular adenoma was identified in the cecum. In this case, the lesion moved to the dependent surface of the colon. This measurement, which was seen on images obtained in both the supine and the prone position, indicated residual fecal material.

View larger version (131K): [in a new window]   Figure 4b. An 11-mm sessile polyp in a 65-year-old man. (a) Transverse CT image obtained in the supine position shows an 11-mm lesion (arrow) on the dorsal surface of the cecum. (b) Transverse CT image obtained in the prone position shows the same filling defect (arrow) on the ventral surface of the cecum. At colonoscopy (images not shown), an 11-mm sessile tubular adenoma was identified in the cecum. In this case, the lesion moved to the dependent surface of the colon. This measurement, which was seen on images obtained in both the supine and the prone position, indicated residual fecal material.