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Comparison of Time-Efficient CT Colonography with Two-and Three-Dimensional Colonic Evaluation for Detecting Colorectal Polyps

Michael Macari1, Andrew Milano2, Michael Lavelle1, Phillip Berman1 and Alec J. Megibow1

1 Department of Radiology, Division of Abdominal Imaging, New York University Medical Center, 560 First Ave., Ste. HW 206, New York, NY 10016.
2 Department of Medicine, Division of Gastroenterology, New York University Medical Center, New York, NY 10016.



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  		Fig. 1A. —56-year-old woman with 5-mm filling defect on dependent surface of transverse colon. Two-dimensional axial supine CT colonographic image obtained at level of transverse colon shows 5-mm filling defect (arrow) on dependent surface of transverse colon.

 


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  		Fig. 1B. —56-year-old woman with 5-mm filling defect on dependent surface of transverse colon. Corresponding three-dimensional (3D) threshold-rendered endoluminal image of A shows polypoid filling defect (arrow). Defect is not haustral fold.

 


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  		Fig. 1C. —56-year-old woman with 5-mm filling defect on dependent surface of transverse colon. Two-dimensional axial prone CT colonographic image at same level as A reveals filling defect (arrow) that is barely perceptible on dependent surface of transverse colon, indicating lesion has moved.

 


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  		Fig. 1D. —56-year-old woman with 5-mm filling defect on dependent surface of transverse colon. Corresponding 3D threshold-rendered endoluminal image of C shows polypoid filling defect (arrow).

 


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  		Fig. 2A. —74-year-old man with 7-mm polyp. Two-dimensional axial image obtained at level of distal descending colon shows 7-mm filling defect (arrow) on dependent surface of transverse colon. Patient was in supine position during imaging.

 


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  		Fig. 2B. —74-year-old man with 7-mm polyp. Corresponding three-dimensional (3D) threshold-rendered endoluminal image of A shows polypoid filling defect (arrow) that does not represent haustral fold.

 


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  		Fig. 2C. —74-year-old man with 7-mm polyp. Two-dimensional axial image at same level as A shows filling defect (arrow) present on nondependent surface of descending colon. The lesion has not moved. Patient was in prone position during imaging.

 


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  		Fig. 2D. —74-year-old man with 7-mm polyp. Corresponding 3D threshold-rendered endoluminal image of C shows polypoid filling defect (arrow). Lesion did not change position when patient was moved from supine to prone position. A 7-mm polyp was identified on conventional colonoscopy.

 


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  		Fig. 3A. —58-year-old woman with prominent haustral fold. Two-dimensional CT colonographic image in transverse colon reveals prominent filling defect (arrow). Differential diagnosis includes polyp versus prominent fold. Patient was in supine position during imaging.

 


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  		Fig. 3B. —58-year-old woman with prominent haustral fold. Three-dimensional threshold-rendered image of filling defect in A shows elongated appearance of defect characteristic of haustral fold (arrow). No polyp was present on colonoscopy.

 


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  		Fig. 4A. —63-year-old man with 3-mm polyp. Conventional colonoscopic image of hepatic flexure reveals 3-mm polyp on haustral fold (arrow).

 


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  		Fig. 4B. —63-year-old man with 3-mm polyp. Corresponding three-dimensional (3D) CT colonographic image at hepatic flexure. Initially, no abnormality was identified using two-dimensional or 3D imaging. In retrospect, tiny filling defect adjacent to haustral fold (arrow) may represent polyp. Small diminutive polyps are difficult to view on CT colonography.

 

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