Biomedical subjects
Publications and source records attributed to Stefaan Gryspeerdt.
Virtual colonoscopy is emerging as a technique for the detection of tumor lesions in the colon. Being a patient-friendly examination, virtual colonoscopy could play an important role in colorectal cancer screening. This article reviews the current state of the art of virtual colonoscopy with future developments and issues to be resolved.
OBJECTIVE: The objective of our study was to assess the efficacy of fecal tagging with a small volume of barium in combination with a reduced cathartic cleansing before CT colonography. MATERIALS AND METHODS: The study consists of a review of 200 patients examined in a clinical setting. Conventional colonoscopy and CT colonography or follow-up were used as the gold standard. All patients prepared for CT colonography the day before the examination with a dedicated low-residue diet. Fecal tagging was performed with 50 mL of barium. The residual feces and fluid were evaluated on a segmental basis. The residual feces was divided in two categories (< 6 mm and > or = 6 mm). The amount of fluid was assessed on the axial slices. The efficacy of tagging was evaluated visually. RESULTS: For the study, 1,200 segments were evaluated. Residual feces was present in 413 segments (34.41%), with feces less than 6 mm in 210 segments (17.5%) and feces 6 mm or greater in 203 segments (16.92%). There was residual fluid in 527 segments (43.91%). Nontagged feces 6 mm or greater was present in 49 segments (4.08%) and nontagged fluid in 178 segments (14.83%). All nontagged feces 6 mm or greater was easy to assess. All fluid redistributed with dual positioning. A total of 65 lesions 6 mm or greater were correctly diagnosed on primary CT colonography. In two patients, two lesions adjacent to each other were misinterpreted as being only one. Another 8-mm lesion was missed. CONCLUSION: In the present study, CT colonography after fecal tagging with 50 mL of barium combined with a reduced cathartic cleansing was feasible.
The aim of this study was to evaluate findings on CT colonography (CTC) in patients with diverticular disease. In a retrospective analysis of 160 consecutive patients, who underwent CTC and conventional colonoscopy (CC), patients with diverticular disease were retrieved. The CTC images were compared with CC and, if possible, with pathology. Findings on both 2D and 3D images are illustrated with emphasis on diagnostic problems and the possible solutions to overcome these problems. Several aspects of diverticulosis were detected: prediverticulosis (3%); global (55.6%); and focal wall thickening (4%) caused by thickened haustral folds, fibrosis, inflammation and adenocarcinoma; diverticula (52%); pseudopolypoid lesions caused by diverticular fecaliths (39%); inverted diverticula (1.2%); and mucosal prolapse (0.6%). Solutions to overcome pitfalls are described as abdominal windowing, content of the pseudopolypoid lesion, comparison of 2D and 3D images, prone-supine imaging and the aspect of the pericolic fat. In this series there were equivocal findings in case of mucosal prolapse (0.6%) and focal wall thickening (4%). Diverticulosis is a challenge for CTC to avoid false-positive diagnosis of polypoid and tumoral disease. Knowledge of possible false causes of polypoid disease and comparison of 2D and 3D images are necessary to avoid false-positive diagnosis. In case of equivocal findings additional conventional colonoscopy should be advised whenever a clinically significant lesion (> or = 1 cm) is suspected.