( a) The endoluminal 3D image shows a flat slightly elevated filling defect with a central depression (arrow), located on a haustral fold adjacent to the ileocecal valve (arrowhead). ( a, b) A 12 mm slightly elevated flat lesion with a central depression. This so-called pseudo mobility may cause confusion with the untagged stool, showing true mobility, i.e., a pseudo-stool appearance. Pedunculated polyps, however, may show a considerable positional shift between the supine and prone acquisitions because of their stalk (Fig. This criterion may help to differentiate true polyps from untagged residual stool that is not attached to the colonic wall and that shows a positional movement. Therefore, they maintain their intraluminal position when the prone and supine scanning positions are compared. On 2D planar images, colorectal polyps typically show a homogeneous internal structure with a soft tissue attenuation. ( c) The corresponding (more.)Ī pedunculated polyp (0-Ip) presents with a round, oval, or lobulated polyp head that is connected to the mucosa by a stalk. ( a)The endoluminal 3D view shows a round polypoid lesion (arrow) ( b) The corresponding prone axial 2D image shows the homogeneous soft-tissue density (arrow) of the lesion. ( a– d) Sessile oval polyp located in the ascending colon. The purpose of this contribution is to focus on benign conditions of the colon and rectum that can be detected during CTC and routine cross-sectional imaging techniques. CTC has become a valuable complementary diagnostic tool to OC, serving as an alternative colonic screening test, and it represents the method of choice in patients with incomplete colonoscopy or with contraindications to colonoscopy. Today, OC represents the diagnostic and therapeutic gold standard in colonic imaging. Indeed, the role of the barium enema in daily radiological imaging has been fading over the last several years due to the emerging use of endoscopic techniques. The barium enema is no longer recommended for this indication. Since its performance is clearly superior to that of the barium enema, it is now recommended as the radiological method of choice for the detection of colorectal neoplasia. CTC has been shown to be as accurate as optical colonoscopy (OC) for the detection of advanced colonic neoplasia, including advanced adenomas and cancers. With the introduction of CT colonography (CTC) to the clinical routine, a noninvasive and safe diagnostic test for imaging the endoluminal aspect of the entire colon became available. Routine cross-sectional imaging techniques, such as standard abdominal CT scans, provide the possibility to evaluate the course of the colon for mural and extracolonic changes. Routine cross-sectional imaging techniques, such as standard abdominal CT scans provide.ĭiagnostic imaging of the colon and the rectum has undergone a remarkable evolution over the last few decades. This contribution summarizes benign conditions of the colon and rectum that can be detected during CTC and routine cross-sectional imaging techniques.ĭiagnostic imaging of the colon and the rectum has undergone a remarkable evolution over the last few decades. Because of the risk of perforation, these conditions are evaluated with standard cross-sectional imaging techniques. The heterogeneous group of inflammatory colonic diseases includes acute diverticular disease, colonic involvement in chronic inflammatory bowel disease, and colonic infectious and noninfectious colitis. These lesions are detected best by CT colonography, a powerful noninvasive test to evaluate the intraluminal aspect of the entire colon, both for colorectal cancer screening and incomplete colonoscopy. Polypoid as well as stenotic lesions include benign adenomatous polyps, various non-adenomatous polypoid findings, and stenotic lesions, commonly seen in chronic diverticular disease. Benign diseases of the colon and rectum include a heterogeneous spectrum of various neoplastic as well as nonneoplastic conditions.
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