By Alain Weissman MD, Jacques Grellet MD, Michel Clot MD (auth.)
It is a brilliant excitement for me to introduce and to suggest this a lot wanted textual content on double distinction exam of the colon. it's aimed either at clinicians who request X-ray examinations of the colon and at radiologists who needs to in keeping with shape and interpret those reports. during the last decade there was renewed curiosity in X-ray exam of the colon regardless of the great advances in endoscopy and imaging tech nology. This renewed curiosity is evidenced by way of the proliferation of recent books on radiology of the colon. even though, prior discussions of double distinction ex amination have focused totally on the method with too little consciousness to the certainty and interpretation of the radiologic photos. This quantity is exclusive in its emphasis at the fundamentals of photo formation and interpretation. It emphasizes the significance of the anteroposterior relation ships of the colon in choosing the distribution of barium and air. It additionally rec ognizes the effect oflocation at the radiologic visual appeal of the lesion. The authors display a profound knowing of the foundations of double distinction prognosis as utilized to the colon. additionally they have an excellent clutch of the gross pathologic adjustments underlying the radiologic pictures. the cloth is gifted in a logical and analytical procedure which could be rather beneficial to the newbie during this box. there are lots of priceless diagrams and the ra diographic illustrations are of fine quality.
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Extra resources for Double Contrast Examination of the Colon: Principles and Practice
One of the major principles in interpreting double contrast is the careful analysis of images and their reasoned interpretation. Since not all images have a corresponding logical explanation (anatomic or artifact), they should be considered pathologic until proven otherwise. While advanced tumors may be more difficult to detect for the nonexperienced observer, they do have different but obvious radiologic signs when the quality of the examination is good and its interpretation thorough. 2 Polyps The major (but not the only) interest of double contrast is in detecting polyps.
The base of the lesion is clearly seen since the lesion is in strict profile. B The incident beam is no longer perpendicular to the axis of the colonic segment. The resulting image of the base is helical and the indentation is not as distinct B c A Fig. 12. Sessile micropolyp (flat): A, three-quarter view: oval image (arrow) ; B, frontal view : Ring shadow (arrow); C, more pronounced three-quarter view: minimal hat sign (arrows) 58 Radiologic Signs in Tumoral Pathology B A Fig. 13. Plateau polyp: A, minimal parietal notch; B, ring shadow without hat sign Fig.
Colonic contour changes caused by the tumor (stenosis, indentation) If filling defects are to be included with these signs, they are less important. With the single contrast technique, the larger the lesion, the more clearly it appears. In double contrast, size does not playas important a role. It is by analysis of all the linear images and filling defects, to determine whether or not they correspond to normal anatomic structures by their form and position, that leads to the detection of abnormal images.
Double Contrast Examination of the Colon: Principles and Practice by Alain Weissman MD, Jacques Grellet MD, Michel Clot MD (auth.)