CT Colonography: A Guide for Clinical Practice

Author: Mang   Thomas  

Publisher: Thieme‎

Publication year: 2013

E-ISBN: 9783131506214

P-ISBN(Hardback):  9783131472618

Subject: R814.42 Computers scanning

Language: ENG

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Description

Highly effective as a minimally invasive diagnostic and screening tool, CT colonography (CTC) is an important part of todays clinical armamentarium.In this concise, step-by-step guidebook, written by specialists who also run training courses in CT colonography, readers will find a wealth of information for everyday practice. From examination methods and image interpretation, to screening and reporting issues, to common mistakes and pitfalls to avoid, this compact book is all-inclusive, ideal for both beginners and more experienced examiners who want to deepen their knowledge of this powerful technique.

Special Features:

  • Full discussion of how to begin, including indications and contraindications, patient preparation, CT examination techniques, and patient risk profile
  • Strategies for data analysis and clinical interpretation, including 2D and 3D applications (virtual visualization), polyp measurement, and computer-assisted detection of polyps
  • Informative, point-by-point sections on clinical findings, starting with normal anatomy of the colon and moving on to common diseases, postoperative conditions, pitfalls and artifacts, and extracolonic involvement
  • More than 400 brilliant, fully labeled illustrations (176 in full-color), including normal CT scans and 2D and 3D reconstructions that demonstrate diagnostic criteria, possible differential diagnoses, and disease states
  • Guidelines for standardizing reports and documenting findings
  • Tips for setting up a virtual colonoscopy service in your clinic or practice

With all methods and techniques following current international guidelines and consensus statements, this book offers easy-to-implement, standardized clinical protocols that can be applied in both the clinic and private practice settings. It is essential for all radiologists and gastroenterologists who perform, interpret and report CTC findings, as well as for physicians who need a reliable overview of this robust and useful detection and screening tool.

Chapter

2 Examination

Patient Preparation

Standard Bowel Preparation Protocol

Marking Stool and Residual Fluid (Fecal/Fluid Tagging)

Reduced Bowel Preparation

Laxative-Free (Noncathartic) CT Colonography

ESGAR Consensus Statement on Bowel Preparation

Colon Distension

Basic Principles and Preparation

Distension Technique

Positioning the Patient

CT Scout Image

CT Examination Technique

Multidetector CT Protocols for CT Colonography

Intravenous Contrast Media

Risk Profile of CT Colonography

Perforation

Cardiovascular Effects

Radiation Exposure

Drug-Induced Reactions

3 Image Interpretation

Data Analysis and Interpretation Strategies

2D Evaluation

3D Evaluation

Performing the Evaluation

3D Applications

Additional 3D Projections

3D Tools

Advanced 3D Visualization Techniques

Polyp Measurement

Criteria for Correct Measurement of Polyps

Techniques for Measuring Polyps

Influence of Fecal Tagging

Discrepancies between CT Colonography and Optical Colonoscopy Findings

Computer-Assisted Detection of Polyps

Principles

Use in Practice

Interpretation Strategies Using CAD

Influence on Interpretation Time

What to Bear in Mind when Using CAD

Future Perspectives

4 Findings at CT Colonography

Normal Anatomy of the Colon and Rectum

CT Morphology of the Bowel Wall

Bowel Segments and Distension

Positional Anomalies and Variations in Length

Diverticular Disease

Pathogenesis

Morphology at CT Colonography

Polypoid Lesions of the Colon

Characterization of Polypoid Lesions at CT Colonography

Polyps

Polypoid Filling Defects of Extracolonic Origin

Malignant Diseases of the Colon and Rectum

Colorectal Carcinoma

Colorectal Lymphoma

Inflammatory Bowel Disease

Diverticulitis

Chronic Inflammatory Bowel Disease

Ileocecal Region

Postoperative Findings

Neoplastic Changes

Inflammatory Changes

CT Colonography for Surveillance after Colorectal Surgery

Follow-Up after Colorectal Surgery

Role of CT Colonography and Examination Technique

Colorectal Anastomoses

Metachronous Lesions of the Colon

Distant Metastases

CT Colonography in Patients with a Colostomy

Colonic Stents

Pitfalls and Artifacts

Technical Errors

Pitfalls in Data Evaluation

Interpretational Errors

Extracolonic Findings

Classification

Frequency and Distribution

Controversial Aspects

Strategies for Improving Detection and Differentiation of Extracolonic Findings

Recommendations on Best Practice for Reporting

5 How to Generate a Useful Report

Components of the Report

Indication

Technical Description

Findings

Impression and Recommendations

Disclaimer on the Limitations of the Method

Inclusion of Images in the Report

Strategies for the Standardization and Documentation of Findings

ESGAR Consensus Statement on the Documentation of Colonic Lesions

C-RADS—CT Colonography Reporting and Data System

American Gastroenterological Association

Controversies in Documentation

6 Screening

Epidemiology of Colorectal Carcinoma

Screening Requirements

Choice of Screening Procedure

Fecal Occult Blood Test

Sigmoidoscopy

Colonoscopy

CT Colonography

7 How to Train for CT Colonography

CT Colonography is Different from CT of the Abdomen

The Colon is a Complex Organ

Common Mistakes in CT Colonography Due to Lack of Expertise

CT Colonography Requires Special Training

Computer-Assisted Detection as a Training Method

How Many Proven Cases Ought to Be Interpreted?

Is CT Colonography Just Too Difficult?

Index

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