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Flat Polyps of the Colon: Detection with 16-MDCT Colonography—Preliminary Results

Seong Ho Park1, Hyun Kwon Ha1, Ah Young Kim1, Kyoung Won Kim1, Moon-Gyu Lee1, Pyo Nyun Kim1, Yong Moon Shin1, Jeong-Sik Byeon2, Suk-Kyun Yang2, Jin Ho Kim2 and Young Il Min2

1 Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-Dong, Songpa-Gu, Seoul, South Korea, 138-040.
2 Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.


Figure 1
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  		Fig. 1A —52-year-old woman with 8 x 2-mm (width x height) flat adenocarcinoma confined within mucosa in rectum. Colonoscopy shows profile view of plaquelike, slightly elevated lesion (arrowheads) in rectum.

 

Figure 2
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  		Fig. 1B —52-year-old woman with 8 x 2-mm (width x height) flat adenocarcinoma confined within mucosa in rectum. 2D transverse images of colon window setting (B: width, 1,500 H; level, -200 H) and soft-tissue window setting (C: width, 400 H; level, 20 H) of CT colonography show slightly elevated lesion (arrow, B and C) on haustral fold of rectum. This lesion was correctly detected on blinded review.

 

Figure 3
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  		Fig. 1C —52-year-old woman with 8 x 2-mm (width x height) flat adenocarcinoma confined within mucosa in rectum. 2D transverse images of colon window setting (B: width, 1,500 H; level, -200 H) and soft-tissue window setting (C: width, 400 H; level, 20 H) of CT colonography show slightly elevated lesion (arrow, B and C) on haustral fold of rectum. This lesion was correctly detected on blinded review.

 

Figure 4
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  		Fig. 1D —52-year-old woman with 8 x 2-mm (width x height) flat adenocarcinoma confined within mucosa in rectum. 3D endoluminal image of CT colonography shows plaquelike, slightly elevated lesion (arrowheads) on haustral fold of rectum. Lesion is more conspicuous on 3D endoluminal view than on 2D views.

 

Figure 5
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  		Fig. 2A —52-year-old man with 8 x 2-mm flat tubular adenoma in sigmoid colon. Colonoscopy shows plaquelike, slightly elevated lesion (arrowheads) in sigmoid colon.

 

Figure 6
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  		Fig. 2B —52-year-old man with 8 x 2-mm flat tubular adenoma in sigmoid colon. and C, 2D transverse images of colon window setting (B: width, 1,500 H; level, -200 H) and soft-tissue window setting (C: width, 400 H; level, 20 H) of contrast-enhanced CT colonography show slightly elevated lesion (arrow, B and C) in distal sigmoid colon. Lesion shows moderate contrast enhancement at venous phase (C). This lesion was correctly detected on blinded review.

 

Figure 7
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  		Fig. 2C —52-year-old man with 8 x 2-mm flat tubular adenoma in sigmoid colon. 2D transverse images of colon window setting (B: width, 1,500 H; level, -200 H) and soft-tissue window setting (C: width, 400 H; level, 20 H) of contrast-enhanced CT colonography show slightly elevated lesion (arrow, B and C) in distal sigmoid colon. Lesion shows moderate contrast enhancement at venous phase (C). This lesion was correctly detected on blinded review.

 

Figure 8
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  		Fig. 2D —52-year-old man with 8 x 2-mm flat tubular adenoma in sigmoid colon. 3D endoluminal image of CT colonography shows plaquelike, slightly elevated lesion (arrow) in sigmoid colon.

 

Figure 9
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  		Fig. 3A —63-year-old man with 7 x 2-mm flat hyperplastic polyp in transverse colon. Colonoscopy shows plaquelike, slightly elevated lesion (arrowheads) on haustral fold of transverse colon.

 

Figure 10
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  		Fig. 3B —63-year-old man with 7 x 2-mm flat hyperplastic polyp in transverse colon. 2D transverse images of colon window setting (B: width, 1,500 H; level, -200 H) and soft-tissue window setting (C: width, 400 H; level, 20 H) of CT colonography show slightly elevated lesion (arrow, B and C) on haustral fold of transverse colon. This lesion was missed on blinded review because of its low conspicuity but was found on unblinded review.

 

Figure 11
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  		Fig. 3C —63-year-old man with 7 x 2-mm flat hyperplastic polyp in transverse colon. 2D transverse images of colon window setting (B: width, 1,500 H; level, -200 H) and soft-tissue window setting (C: width, 400 H; level, 20 H) of CT colonography show slightly elevated lesion (arrow, B and C) on haustral fold of transverse colon. This lesion was missed on blinded review because of its low conspicuity but was found on unblinded review.

 

Figure 12
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  		Fig. 3D —63-year-old man with 7 x 2-mm flat hyperplastic polyp in transverse colon. 3D endoluminal image of CT colonography shows plaquelike, slightly elevated lesion (arrowheads) on haustral fold of transverse colon.

 

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