Abdominal Imaging

, Volume 32, Issue 5, pp 589–595 | Cite as

Spectrum of Normal Findings, Anatomic Variants and Pathology of Ileocecal Valve: CT Colonography Appearances and Endoscopic Correlation

  • Franco Iafrate
  • Marco Rengo
  • Riccardo Ferrari
  • Pasquale Paolantonio
  • Michela Celestre
  • Andrea Laghi
Article

Abstract

Knowledge of the potential variants of ileocecal valve, the most frequent pathologic conditions as well as some pitfalls encountered during the analysis of CT Colonography images are thus indispensable for radiologists who perform and interpret such examinations and for general practitioners who are approaching this technique. Awareness of these different diagnostic possibilities is mandatory for radiologists evaluating CT Colonography datasets. Combined analysis of 2D axial and reformatted slices and 3D endouminal views provides the highest level of diagnostic accuracy. We present the multidetector CT Colonography findings with endoscopic correlation and discuss the possible pathologies and the practical implications

Keywords

Computed tomographic colonography Virtual colonoscopy Video colonoscopy Ileocecal valve 

References

  1. 1.
    Hara AK, Johnson CD, Reed JE, Ehman JE, Ilstrup DM (1996) Colorectal polyp detection with CT colography: two- versus three-dimensional techniques. Radiology 200:49–54PubMedGoogle Scholar
  2. 2.
    Dachman AH, Kuniyoshi JK, Boyle CM, et al. (1998) CT colonography with three-dimensional problem solving for detection of colonic polyps. AJR 171:989–995PubMedGoogle Scholar
  3. 3.
    Macari M, Milano A, Lavelle M, Berman P, Megibow AJ (2000) Comparison of time-efficient CT colonography with two- and three-dimensional colonic evaluation for detecting colorectal polyps. AJR 174:1543–1549PubMedGoogle Scholar
  4. 4.
    Hara AK, Johnson CD, Reed JE, et al. (1997) Detection of colorectal polyps with CT Colonography: initial assessment of sensitivity and specificity. Radiology 205:59–65PubMedGoogle Scholar
  5. 5.
    Pickhardt PJ, Choi JR, Hwang I, Butler JA, Puckett ML, Hildebrandt HA, Wong RK, Nugent PA, Mysliwiec PA, Schindler WR (2003) Related articles, links computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults N Engl J Med 349(23):2191–2200PubMedCrossRefGoogle Scholar
  6. 6.
    Fenlon HM, NUnes DP, Schroy PC III, Barish MA, Clarke PD, Ferrucci JT (1999) A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps. N Engl J Med 341:1496–1503PubMedCrossRefGoogle Scholar
  7. 7.
    Yee J, Kumar NN, Hung R, Akerkar G, Kumar P, Wall S (2003) Comparison of supine and prone scanning separately and in combination at CT colonography. Radiology 226:653–661PubMedCrossRefGoogle Scholar
  8. 8.
    Chen SC, Lu DSK, Hecht JR, Kedall BM (1999) CT colonography: value of scanning in both the supine and prone positions. AJR 172:595–599PubMedGoogle Scholar
  9. 9.
    Barish MA, Soto JA, Ferrucci JT (2005) Consensus on current clinical practice of virtual colonoscopy. AJR 184:786–792PubMedGoogle Scholar
  10. 10.
    Taylor SA, Laghi A, Lefere P, Halligan S, Stoker J (2006) European society of gastrointestinal and abdominal radiology (ESGAR): consensus statement on CT colonography. Eur Radiol 17(2):575CrossRefGoogle Scholar
  11. 11.
    Lockart RD, Hamilton GF, Fyfe FW (1959) Large intestine. In: Lockart RD, Hamilton GF, Fyfe FW (eds) Anatomy of the human body. London: Faber and Faber, pp 524Google Scholar
  12. 12.
    Yitta S, Tatineny KC, Cipriani NA, Dachman AH (2006) Related articles, characterization of normal ileocecal valve density on CT colonography. J Comput Assist Tomogr 30(1):58–61PubMedCrossRefGoogle Scholar
  13. 13.
    Fleischner FG, Bernstein C (1954) Roentgen-anatomical studies of the normal ileocecal valve Radiology 54:43–58Google Scholar
  14. 14.
    Regge D, Gallo TM, Nieddu G, Galatola G,Fracchia R, Neri E, Vagli P, Bartolozzi C (2005) Ileocecal valve imaging on computed tomographic colonographyn Abdom Imaging 30(1):20–25PubMedCrossRefGoogle Scholar
  15. 15.
    Macari M, Megibow AJ (2001) Pitfalls of using three dimensional CT Colonography with two dimensional imaging correlation AJR 176:137–143PubMedGoogle Scholar
  16. 16.
    Burling D, Taylor SA, Halligan S, Gartner L, Paliwalla M Peiris C, Singh L, Bassett P, Bartram C (2006) Automated isufflation of carbon dioxide for MDCT colonography: distension and patient experience compared with manual insufflation. AJR 186(1):96–103PubMedCrossRefGoogle Scholar
  17. 17.
    Iafrate F, Laghi A, Paolantonio P, et al. (2004) Colonic distension using meccanical CO2 insufflator versus manual air distension [Abstract]. Radiological Society of North America scientific assembly and annual meeting program. Oak Brook: Radiological Society of North America, p 432Google Scholar
  18. 18.
    Lasser EC, Rigler LG (1955) Ileocecal valve syndrome. Gastroenterology 28:1–16PubMedGoogle Scholar
  19. 19.
    Hinkel CL (1952) Roentgenological examination and evaluation of the ileocecal valve. AJR 68:171–182Google Scholar
  20. 20.
    El-Amin LC, Levine MS, Rubesin SE, et al. (2003) Ileocecal valve: spectrum of normal findings at double-contrast barium enema examination. Radiology 227:52–58PubMedCrossRefGoogle Scholar
  21. 21.
    Berk RN, David GB, Cholhassey FB (1973) Lipomatosis of the ileocecal valve AJR 119:323–328Google Scholar
  22. 22.
    Yoruk G, Aksoz K, Buyrac Z, et al. (2004) Adenocarcinoma of the Ileocecal valve: Report of a case. Turk J Gastroenterol 15(4):268–269PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Franco Iafrate
    • 1
    • 2
  • Marco Rengo
    • 1
  • Riccardo Ferrari
    • 1
  • Pasquale Paolantonio
    • 1
  • Michela Celestre
    • 1
  • Andrea Laghi
    • 1
  1. 1.Department of Radiological SciencesUniversity of Rome “La Sapienza”LatinaItaly
  2. 2.RomeItaly

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