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Laxative-Free CT Colonography

Philippe Lefere1, Stefaan Gryspeerdt, Marc Baekelandt and Bartel Van Holsbeeck

1 All authors: Department of Radiology, Stedelijk Ziekenhuis, Bruggesteenweg 90, Roeselare B-8800, Belgium.



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Fig. 1. Coronal reformatted CT colonographic scan was obtained in group 4 patient who ingested 50 mL of 40% weight/volume barium suspension over course of 1 day. All residue with density exceeding 150 H is electronically labeled in green. Residual stool is seen in cecoascending and descending segments of colon. Percentage of residue labeled was scored as 100%.

 


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Fig. 2. Bar graph shows percentage of visual labeling of fecal residue seen in six segments of colon in five groups of patients following different preparation protocols for CT colonography. Amount of labeling was scored per segment of colon and per patient group. Asc = ascending colon, Transv = transverse colon, Desc = descending colon.{blacksquare} = group 1, {lt_blk_squ} = group 2, {graysqu} = group 3, {lt_gray_squ} = group 4, and {square} = group 5.

 


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Fig. 3. Axial CT colonographic scan obtained in group 2 patient shows tiny amount of untagged fecal residue (arrowheads) in descending colon, resulting in low average labeling score of 21%. However, colonic wall could be adequately examined. No lesions were detected. This finding was confirmed on conventional colonoscopy. Very good tagging is seen in ascending and transverse segments of colon (arrows).

 


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Fig. 4. Axial CT colonographic scan obtained in group 4 patient shows dense and homogeneous tagging of residual stool (arrows).

 


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Fig. 5. Axial CT colonographic scan obtained in group 1 patient shows untagged residual stool in rectum (arrow). Stool is easily recognizable because it is completely surrounded by barium. Some inhomogeneous tagging with air inclusions is seen in the other stool ball (arrowheads).

 

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