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DOI: 10.1148/radiol.2442060837
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CT Colonography in 546 Patients with Incomplete Colonoscopy1

Laurian Copel, MD, Jacob Sosna, MD, Jonathan B. Kruskal, MD, PhD, Vassilios Raptopoulos, MD, Richard J. Farrell, MD, and Martina M. Morrin, MD

1 From the Department of Radiology, Assaf-Harofeh Medical Center, Sackler School of Medicine, Zerifin, Israel 70300 (L.C.); Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (J.S.); and Departments of Radiology (J.S., J.B.K., V.R., M.M.M.) and Gastroenterology (R.J.F.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass. Received May 13, 2006; revision requested July 12; revision received October 23; accepted November 21; final version accepted January 8, 2007. Address correspondence to L.C. (e-mail: lcopel{at}gmail.com).


Figure 1A
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  		Figure 1a: Cecal carcinoma in an 80-year-old man with abdominal pain and iron-deficiency anemia. The colonoscope could not be advanced beyond the hepatic flexure because of an extremely tortuous colon. (a) Transverse CT image obtained with the patient in the supine position shows a thickened fold with a mass-like appearance (arrows) in the cecum. (b) Coronal multiplanar reformation shows a concentric thickening of a fold (arrows) in the cecum. (c) Mass within a fold covered by fresh blood (arrows) in the cecum seen at repeat colonoscopy performed after CT colonography. Adenocarcinoma was confirmed with colonic biopsy.

 

Figure 1B
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  		Figure 1b: Cecal carcinoma in an 80-year-old man with abdominal pain and iron-deficiency anemia. The colonoscope could not be advanced beyond the hepatic flexure because of an extremely tortuous colon. (a) Transverse CT image obtained with the patient in the supine position shows a thickened fold with a mass-like appearance (arrows) in the cecum. (b) Coronal multiplanar reformation shows a concentric thickening of a fold (arrows) in the cecum. (c) Mass within a fold covered by fresh blood (arrows) in the cecum seen at repeat colonoscopy performed after CT colonography. Adenocarcinoma was confirmed with colonic biopsy.

 

Figure 1C
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  		Figure 1c: Cecal carcinoma in an 80-year-old man with abdominal pain and iron-deficiency anemia. The colonoscope could not be advanced beyond the hepatic flexure because of an extremely tortuous colon. (a) Transverse CT image obtained with the patient in the supine position shows a thickened fold with a mass-like appearance (arrows) in the cecum. (b) Coronal multiplanar reformation shows a concentric thickening of a fold (arrows) in the cecum. (c) Mass within a fold covered by fresh blood (arrows) in the cecum seen at repeat colonoscopy performed after CT colonography. Adenocarcinoma was confirmed with colonic biopsy.

 

Figure 2A
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  		Figure 2a: Adenomatous polyp of 10 mm of the middle transverse colon in a 57-year-old patient who underwent routine screening colonoscopy that was stopped at the distal transverse colon because of severe discomfort. (a) Transverse CT image obtained with the patient in the supine position shows 10-mm polypoid lesion (arrow) in the middle transverse colon. (b) Coronal multiplanar reformation shows the polypoid lesion (arrow) in the middle transverse colon lying on a fold. (c) Polyp (arrows) lying on a fold in the transverse colon at repeat colonoscopy performed after the CT colonography. Histologic evaluation revealed an adenomatous polyp.

 

Figure 2B
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  		Figure 2b: Adenomatous polyp of 10 mm of the middle transverse colon in a 57-year-old patient who underwent routine screening colonoscopy that was stopped at the distal transverse colon because of severe discomfort. (a) Transverse CT image obtained with the patient in the supine position shows 10-mm polypoid lesion (arrow) in the middle transverse colon. (b) Coronal multiplanar reformation shows the polypoid lesion (arrow) in the middle transverse colon lying on a fold. (c) Polyp (arrows) lying on a fold in the transverse colon at repeat colonoscopy performed after the CT colonography. Histologic evaluation revealed an adenomatous polyp.

 

Figure 2C
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  		Figure 2c: Adenomatous polyp of 10 mm of the middle transverse colon in a 57-year-old patient who underwent routine screening colonoscopy that was stopped at the distal transverse colon because of severe discomfort. (a) Transverse CT image obtained with the patient in the supine position shows 10-mm polypoid lesion (arrow) in the middle transverse colon. (b) Coronal multiplanar reformation shows the polypoid lesion (arrow) in the middle transverse colon lying on a fold. (c) Polyp (arrows) lying on a fold in the transverse colon at repeat colonoscopy performed after the CT colonography. Histologic evaluation revealed an adenomatous polyp.