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CT Colonography Using 16-MDCT in the Evaluation of Colorectal Cancer

Don Jin Chung1, Kyu Chan Huh2, Won Jun Choi3 and Jae Kyun Kim1

1 Department of Radiology, University of Konyang School of Medicine, 685 Gasuwon-dong, Seo-gu, Daejeon 302-718, Korea.
2 Department of Gastroenterology, University of Konyang School of Medicine, Daejeon 302-718, Korea
3 Department of Surgery, University of Konyang School of Medicine, Daejeon 302-718, Korea.



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Fig. 1A. 52-year-old man with polypoid occlusive carcinoma in rectum. Colonoscopic image shows large, bleeding mass obstructing rectum, which could not be crossed by colonoscope.

 


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Fig. 1B. 52-year-old man with polypoid occlusive carcinoma in rectum. Virtual colonoscopy image obtained after enhancement, with patient supine, reveals rectal mass (arrow).

 


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Fig. 1C. 52-year-old man with polypoid occlusive carcinoma in rectum. Well-visualized ray-sum image, similar to that obtained with barium enema, shows mass (arrow).

 


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Fig. 1D. 52-year-old man with polypoid occlusive carcinoma in rectum. Coronal multiplanar reconstruction image shows tumor invasion through muscularis propria into subserosa (arrow) (T3), with no regional lymph node (N0).

 


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Fig. 2A. 65-year-old man with colonic polyp that was missed on conventional colonoscopy. Conventional colonoscopy image shows large, lobulated mass in sigmoid colon. Colonoscope could not cross mass.

 


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Fig. 2B. 65-year-old man with colonic polyp that was missed on conventional colonoscopy. Ray-sum image shows mass (arrow) in sigmoid colon.

 


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Fig. 2C. 65-year-old man with colonic polyp that was missed on conventional colonoscopy. Mass is well visualized (arrow) on virtual colonoscopy image.

 


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Fig. 2D. 65-year-old man with colonic polyp that was missed on conventional colonoscopy. Virtual colonoscopy image shows small polyp (arrow) descending the colon, proximal to mass.

 


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Fig. 3A. 61-year-old man with false-positive findings for colonic polyp. Virtual colonoscopy image shows small, elevated lesion (arrow) suspected, by consensus, of being a polyp.

 


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Fig. 3B. 61-year-old man with false-positive findings for colonic polyp. Wide-window-setting transverse CT image shows small, suggestive polyp (arrow).

 


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Fig. 3C. 61-year-old man with false-positive findings for colonic polyp. Narrow-window-setting transverse CT colonography image shows tiny gas bubble at center of elevated lesion (arrow); this finding confirmed presence of residual fecal material. No polyp was seen on colonoscopy.

 


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Fig. 4A. 59-year-old man with false-negative findings for colonic polyp. Conventional colonoscopy image shows small polyp (arrow).

 


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Fig. 4B. 59-year-old man with false-negative findings for colonic polyp. Virtual colonoscopy (B) and transverse CT (C) images show fluid-filled descending colon (arrows). Lesion was masked by fluid and missed on CT colonography.

 


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Fig. 4C. 59-year-old man with false-negative findings for colonic polyp. Virtual colonoscopy (B) and transverse CT (C) images show fluid-filled descending colon (arrows). Lesion was masked by fluid and missed on CT colonography.

 


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Fig. 5A. 48-year-old woman with overstaged T2 colon cancer. Axial (A) and sagittal (B) reformatted images clearly show irregular rectal mass with perirectal fat stranding (arrows). Initial preoperative diagnosis was T3 lesion, but lesion proved to be T2.

 


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Fig. 5B. 48-year-old woman with overstaged T2 colon cancer. Axial (A) and sagittal (B) reformatted images clearly show irregular rectal mass with perirectal fat stranding (arrows). Initial preoperative diagnosis was T3 lesion, but lesion proved to be T2.

 

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