Atlas of Virtual Colonoscopy by David J. Vining (auth.), Abraham H. Dachman MD (eds.)

By David J. Vining (auth.), Abraham H. Dachman MD (eds.)

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Throughout this chapter, we will emphasize practical aspects of patient preparation that can improve both patient comfort and the quality of colonography images. Patient Education Patients often experience considerable anxiety as they approach colon examinations, in part due to their expectation of perceived embarrassment and discomfort (Weitzman 2001). This expectation of discomfort contributes to the relatively low compliance rate of individuals for recommended colon cancer screening regimens (Brown 1990; Anderson and May 1995).

Until a clear consensus emerges, it is advisable to educate patients as to the importance of the bowel preparation to promote compliance. Detailed evaluation of the colon is markedly diminished in the setting of an unprepped colon. In addition to purgation cleansing of the bowel, diet modification has been employed to improve the quality of the preparation. In particular, it is common practice to advise patients to consume a low-residue diet for the 48 hours prior to exam. Foods containing large amounts of fiber, such as undercooked meats, fresh fruits, and vegetables, are to be avoided in favor of well-cooked items.

However, careful inspection of MPR and endoluminal images usually allows differentiation of linear (fold) morphology from true polypoid morphology. 5), linear morphology is indicative of a fold. On occasion, bulbous folds can be difficult to differentiate from polyps. If there is concern, and the lesion is of substantial size (as measured on the 2D image), colonoscopy is recommended for differentiation in these cases. 13A). ; Fenlon et al. 1998). 13B). When a diverticulum is impacted with fecal material, it may appear raised, mimicking a polyp.

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