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DOI:10.2214/AJR.06.0436
AJR 2007; 188:953-959
© American Roentgen Ray Society


Pictorial Essay

Flat Colorectal Neoplasms: Definition, Importance, and Visualization on CT Colonography

Seong Ho Park1, Seung Soo Lee1, Eugene K. Choi2, So Yeon Kim1, Suk-Kyun Yang3, Jin Ho Kim3 and Hyun Kwon Ha1

1 Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-2dong, Songpa-gu, 138-736, Seoul, Korea.
2 Weill Medical College of Cornell University, New York, NY 10021.
3 Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

OBJECTIVE. We discuss the definition of flat colorectal neoplasms, their clinical importance, CT colonography (CTC) findings, techniques for better visualization on CTC, and diagnostic pitfalls of such lesions.

CONCLUSION. Flat lesions appear on CTC as plaque-shaped mucosal elevations with or without a central depression, thickened haustral folds, and nodular mucosal surfaces. The sensitivity and optimal techniques of CTC for the detection of flat lesions have not yet been established. Three-dimensional endoluminal fly-through may be helpful for lesion detection. Fecal tagging helps in the distinction of true flat lesions from feces. IV contrast enhancement and the review with intermediate soft-tissue window settings, although not routinely used for CTC, may also help lesion visualization.

Keywords: colon • colonography • colonoscopy • colorectal cancer • CT colonography • oncologic imaging • virtual colonoscopy


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