Stool is the most frequent cause of false positive findings at CT colonography (Fletcher et al. 2000). There are several imaging characteristics, which usually aid in the identification of stool. Stool has a heterogeneous internal attenuation, often with internal air (Fig. 14.16). Additionally, stool particles usually lie along the dependent colonic wall and change location with changes in patient positioning (Fig. 14.17). On 3D normal endoluminal images,

Fig. 14.14a-c. Lipoma. Note the smoothly marginated polypoid filling defect (a,b, arrows) with internal fatty attenuation (c, arrow)

Fig. 14.15a,b. Diverticulitis may mimic an annular constricting neoplasm when the majority of inflammation is intramural, rather than extending into the pericolonic tissues (a,b). Contrast enhancement demonstrates mural stratification (a, arrow)

Fig. 14.16.a Stool may mimic polyps on 3D-endoluminal images. b,c In this case, internal air and lack of a clear point of attachment to the wall on 2D images (arrows) distinguishes stool from polyp

Fig. 14.17a,b. Stool particles generally change location with changes in patient positioning. Stool is usually located along the dependent wall (arrows)

stool often demonstrates sharp intraluminal projections (Fig. 14.18). Stool particles will demonstrate a lack of enhancement when intravenous contrast is given.

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Managing Diverticular Disease

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