Carpet Lesion on CT Colonography: A Potential Pitfall
Greg M. Galdino1 and
Judy Yee2
1 Department of Radiology, University of California at San Francisco, 563 20th
Ave., San Francisco, CA 94121
2 Department of Radiology, University of California at San Francisco, San
Francisco Veterans Administration, 4150 Clement St., San Francisco, CA
94121
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Fig. 1A. —81-year-old man with history of prostate cancer, diverticulosis, and
colonic polyps presented for follow-up screening. Fiberoptic colonoscopy image
shows extreme nodularity of surface of lesion and similar appearance of tissue
of surrounding colonic mucosa in cecum. Lesion appears to involve surface of
entire haustral fold. Lesion was initially diagnosed on fiberoptic
colonoscopy.
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Fig. 1B. —81-year-old man with history of prostate cancer, diverticulosis, and
colonic polyps presented for follow-up screening. Image from double-contrast
barium enema study shows lesion (arrows) en face and reveals
irregular mucosal contour involving half of cecal haustral fold compared with
smooth contour of remaining half of fold. This lesion was missed on initial
interpretation.
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Fig. 1C. —81-year-old man with history of prostate cancer, diverticulosis, and
colonic polyps presented for follow-up screening. Two-dimensional axial CT
colonography image with patient in supine position shows irregular, nodular
appearance of lesion and thickened appearance of haustral fold compared with
other folds present on image. Lesion spans entire haustral fold
(arrows) on this image. Carpet lesion was initially interpreted as
adherent stool on haustral fold.
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Fig. 1D. —81-year-old man with history of prostate cancer, diverticulosis, and
colonic polyps presented for follow-up screening. Three-dimensional
endoluminal CT colonography image shows nodular, irregular surface texture of
lesion on fold as well as normal smooth surface of fold.
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Fig. 1E. —81-year-old man with history of prostate cancer, diverticulosis, and
colonic polyps presented for follow-up screening. Two-dimensional axial CT
colonography image with patient in prone position shows lesion
(arrow) is almost completely obscured by residual fluid.
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Fig. 1F. —81-year-old man with history of prostate cancer, diverticulosis, and
colonic polyps presented for follow-up screening. Two-dimensional coronal CT
colonography image with patient in supine position shows carpet lesion
(arrows) and adjacent normal mucosa on same fold.
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Fig. 2A. —50-year-old man with incomplete cleansing and large amount of solid,
residual stool. Two-dimensional axial CT colonography image with patient in
supine position shows that large amount of solid residual stool adherent to
haustral fold (arrows) can mimic appearance of carpet lesion on CT
colonography. Note similar irregular, nodular surface making fold appear
thickened.
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Fig. 2B. —50-year-old man with incomplete cleansing and large amount of solid,
residual stool. Three-dimensional endoluminal CT colonography image shows
similar surface texture to carpet lesion.
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Copyright © 2003 by the American Roentgen Ray Society.
