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Ascending colon rotation following patient positional change during CT colonography: a potential pitfall in interpretation

European Radiology volume 21, pages 353–359 (2011)Cite this article

Abstract

Objective

To investigate the degree and pattern of ascending colonic rotation as patients moved from supine to prone positions during CTC.

Methods

A search of our CTC and colonoscopy database found 37 patients (43 eligible lesions) who fulfilled the following criteria: colonoscopy-proven sessile polyps ≥6 mm in the straight mid-ascending colon, lesion visualisation in both supine and prone CTC, and optimal colonic distension. A coordinate system was developed to designate the polyp radial location (°) along the luminal circumference, unaffected by rotation of the torso. The degree/direction of polyp radial location change (i.e. ascending colonic rotation) between supine and prone positions correlated with anthropometric measurements.

Results

Movement from supine to prone positions resulted in a change in the radial polyp location of between −23° and 79° (median, 21°), demonstrating external rotation of the ascending colon in almost all cases (2° to 79° in 36/37 patients and 42/43 lesions). The degree/direction of rotation mildly correlated with the degree of abdominal compression in the anterior-posterior direction in prone position (r = 0.427 [P = 0.004] and r = 0.404 [P = 0.007]).

Conclusion

The ascending colon was usually found to rotate externally as patients moved from supine to prone positions, partly dependent on the degree of abdominal compression.

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Acknowledgements

Seong Ho Park is a research consultant for Infinitt (Seoul, Korea).

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Author notes

  1. Ji Yeon Kim

    Present address: Department of Radiology, The Catholic University of Korea, St. Vincent’s Hospital, 93 Ji-dong, Paldal-ku, Suwon, Kyunggi-do, 442-723, South Korea

Affiliations

  1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736, South Korea

    Ji Yeon Kim, Seong Ho Park, Seung Soo Lee, Ah Young Kim & Hyun Kwon Ha

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  1. Ji Yeon Kim
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Correspondence to Seong Ho Park.

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Kim, J.Y., Park, S.H., Lee, S.S. et al. Ascending colon rotation following patient positional change during CT colonography: a potential pitfall in interpretation. Eur Radiol 21, 353–359 (2011). https://doi.org/10.1007/s00330-010-1928-y

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  • DOI: https://doi.org/10.1007/s00330-010-1928-y

Keywords

  • CT colonography
  • Ascending colon
  • Rotation
  • Mobility
  • Diagnostic error
  • Diagnostic pitfall