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Diagnostic Performance of Primary 3-Dimensional Computed Tomography Colonography in the Setting of Colonic Diverticular Disease  Matthew F. Sanford, Perry.

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Presentation on theme: "Diagnostic Performance of Primary 3-Dimensional Computed Tomography Colonography in the Setting of Colonic Diverticular Disease  Matthew F. Sanford, Perry."— Presentation transcript:

1 Diagnostic Performance of Primary 3-Dimensional Computed Tomography Colonography in the Setting of Colonic Diverticular Disease  Matthew F. Sanford, Perry J. Pickhardt  Clinical Gastroenterology and Hepatology  Volume 4, Issue 8, Pages (August 2006) DOI: /j.cgh Copyright © 2006 American Gastroenterological Association Terms and Conditions

2 Figure 1 CTC in an asymptomatic 71-year-old woman. (A) Prone axial 2D image shows multiple sigmoid diverticula (arrowheads), associated with moderate wall thickening and luminal narrowing. A 6-mm polyp tubular adenoma (arrow) is difficult to distinguish from thickened folds on 2D evaluation. (B) Prone 3D endoluminal view shows the same polyp with greater conspicuity relative to thickened sigmoid folds and diverticula in the background. Clinical Gastroenterology and Hepatology 2006 4, DOI: ( /j.cgh ) Copyright © 2006 American Gastroenterological Association Terms and Conditions

3 Figure 2 CTC in an asymptomatic 56-year-old man. (A) Supine axial 2D image shows extensive sigmoid diverticular disease with luminal narrowing, fold thickening, and scattered diverticula. Note how some thickened folds have a bulbous, polypoid appearance. A 1.2-cm polyp is present (arrow), which could be mistaken easily for untagged stool in the fluid pool or a thickened fold. (B) Prone axial 2D image shows the same diseased sigmoid segment now with areas of luminal collapse. The polyp (arrowhead) is identified as a pedunculated lesion that simulates the adjacent folds on 2D imaging. (C) Prone 3D endoluminal view shows how the pedunculated polyp (arrowhead) is distinguished easily from the thickened circular folds on this projection. Note diverticulum in foreground. (D) Digital photograph from OC performed the same day as CTC shows the pedunculated sigmoid polyp and thickened colonic folds. The lesion was a tubular adenoma at histologic evaluation. Clinical Gastroenterology and Hepatology 2006 4, DOI: ( /j.cgh ) Copyright © 2006 American Gastroenterological Association Terms and Conditions

4 Figure 3 Colon maps in 2 different patients with moderate or greater CDD. (A) Moderate CDD with multiple left-sided diverticula is present with associated luminal narrowing of the sigmoid and descending colon. (B) Extensive CDD with marked distortion of the sigmoid colon is present caused by prominent fold thickening, luminal narrowing, and multiple diverticula. Clinical Gastroenterology and Hepatology 2006 4, DOI: ( /j.cgh ) Copyright © 2006 American Gastroenterological Association Terms and Conditions


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