Colonic folds can be particularly complex, particularly in the flexures and rectum. Fused folds are common in these locations (Fig. 14.5). Fused folds are simply recognized by their three-dimensional shape. Occasionally one may visualize focal thickening within a fold. Folds can be distinguished from polyps due to the obtuse margins, internal attenuation (which will often contain some fat) and the non-focality of the lesion. Thickened folds are usually seen in regions of suboptimal colonic distension, so comparison with the complementary dataset in a different position with improved distention will frequently assist in the identification of thickened folds (Fig. 14.6).

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