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CT Colonography After Fecal Tagging with a Reduced Cathartic Cleansing and a Reduced Volume of Barium

Department of Radiology, Stedelijk Ziekenhuis, Bruggesteenweg 90, Roeselare B-8800, Belgium.

View larger version (130K): [in a new window]   Fig. 1. —Coronal reformatted image of 55-year-old man shows tagged residual feces 6 mm or greater (white arrow) and less than 6 mm (arrowheads) in ascending colon. Descending colon and rectosigmoid (black arrows) are clean.

View larger version (159K): [in a new window]   Fig. 2A. —64-year-old woman. Supine image of rectum shows nontagged material 6 mm or greater with small hyperdense spot in dependent part of rectum (arrow). Hyperdense spot probably corresponds to some barium.

View larger version (165K): [in a new window]   Fig. 2B. —64-year-old woman. Prone view of rectum shows nontagged feces has moved to anterior rectal wall (arrow). Image shows nontagged feces 6 mm or greater in rectum. This could be caused by remnants of bisacodyl suppository.

View larger version (103K): [in a new window]   Fig. 3A. —73-year-old woman. Supine scan is typical image of nontagged feces 6 mm or greater in transverse colon, presenting as rounded opacity with hyperdense peripheral ring and hypodense center and floating in small pool of barium in dependent part of transverse colon (thick arrow). Efficient tagging of fluid is seen in both descending (thin arrows) and ascending colon with some layering at this level (arrowheads).

View larger version (84K): [in a new window]   Fig. 3B. —73-year-old woman. Prone scan shows nontagged feces (arrow) has moved to ventral portion of transverse colon and is still floating in barium.

View larger version (122K): [in a new window]   Fig. 4A. —68-year-old man. Coronal reformatted image through descending colon and part of transverse colon with patient in supine position shows fluid covers 50% or more of colonic lumen on axial slices. Efficient tagging of residual fluid is shown. Densities in fluid correspond to small tagged fecal particles.

View larger version (110K): [in a new window]   Fig. 4B. —68-year-old man. Coronal reformatted image of same region with patient in prone position shows good redistribution of tagged fluid.

View larger version (110K): [in a new window]   Fig. 5. —52-year-old man. CT image shows nontagged fluid (arrowheads) covers less than 25% of colonic lumen in ascending colon and 25-50% (thick arrow) in descending colon. Some tagged feces (thin straight arrow) can be seen in ascending colon, and some nontagged fluid (curved arrows) is visible in small bowel.

View larger version (118K): [in a new window]   Fig. 6A. —61-year-old man. Supine view shows rounded filling defect (arrow) surrounded by barium in cecum: Is it a lesion or nontagged feces?

View larger version (108K): [in a new window]   Fig. 6B. —61-year-old man. Prone view shows same filling defect (thick arrow) remains on dependent side of colon, thus becoming highly suggestive of small polypoid lesion. Some nontagged fluid (thin arrows) can be seen in transverse colon. Lesion was confirmed on conventional colonoscopy; anatomopathology showed adenoma with low-grade dysplasia.

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