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CT Colonography After Fecal Tagging with a Reduced Cathartic Cleansing and a Reduced Volume of Barium

Department of Radiology, Stedelijk Ziekenhuis, Bruggesteenweg 90, Roeselare B-8800, Belgium.

OBJECTIVE. The objective of our study was to assess the efficacy of fecal tagging with a small volume of barium in combination with a reduced cathartic cleansing before CT colonography.

MATERIALS AND METHODS. The study consists of a review of 200 patients examined in a clinical setting. Conventional colonoscopy and CT colonography or follow-up were used as the gold standard. All patients prepared for CT colonography the day before the examination with a dedicated low-residue diet. Fecal tagging was performed with 50 mL of barium. The residual feces and fluid were evaluated on a segmental basis. The residual feces was divided in two categories (< 6 mm and 6 mm). The amount of fluid was assessed on the axial slices. The efficacy of tagging was evaluated visually.

RESULTS. For the study, 1,200 segments were evaluated. Residual feces was present in 413 segments (34.41%), with feces less than 6 mm in 210 segments (17.5%) and feces 6 mm or greater in 203 segments (16.92%). There was residual fluid in 527 segments (43.91%). Nontagged feces 6 mm or greater was present in 49 segments (4.08%) and nontagged fluid in 178 segments (14.83%). All nontagged feces 6 mm or greater was easy to assess. All fluid redistributed with dual positioning. A total of 65 lesions 6 mm or greater were correctly diagnosed on primary CT colonography. In two patients, two lesions adjacent to each other were misinterpreted as being only one. Another 8-mm lesion was missed.

CONCLUSION. In the present study, CT colonography after fecal tagging with 50 mL of barium combined with a reduced cathartic cleansing was feasible.

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