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Fig. 1D. —Colonic distention rating system. Axial two-dimensional CT scans from virtual colonoscopy show air-insufflated sigmoid colon with patient in supine position. Scans reveal the following segments of varying distention from different patients: optimal distention (rating, 4; A), good distention (rating, 3; B), poor distention (rating, 2; C), and nondistended (rating, 1; D). Arrow in D indicates collapsed sigmoid colon (rating, 1).