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Spectrum of Normal and Abnormal CT Appearances of the Ileocecal Valve and Cecum with Endoscopic and Surgical Correlation¹

¹ From the Department of Diagnostic Radiology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259 (A.C.S., S.D.B., A.K.H., C.D.J.); Department of Radiology, Mayo Clinic, Rochester, Minn (J.G.F., J.L.F.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (C.O.M.). Recipient of a Certificate of Merit award for an education exhibit at the 2005 RSNA Annual Meeting. Received September 5, 2006; revision requested October 30 and received February 23, 2007; accepted March 1. J.G.F. developed a Continuing Medical Education course for E-Z-EM, is supported in part by Siemens Medical Systems, and has a licensing agreement with GE Healthcare; J.L.F. is a medical advisor for GE Medical Systems; C.D.J. has licensing agreements with GE Medical Systems and E-Z-EM; and A.J.H. has a licensing agreement with GE Medical Systems. All remaining authors have no financial relationships to disclose. Address correspondence to A.C.S. (e-mail: silva.alvin{at}mayo.edu).

Because of advances in imaging technology, evaluation of the gastrointestinal tract is increasingly being performed with cross-sectional imaging (eg, computed tomographic [CT] colonography, CT enterography). However, the diagnosis of disease involving the ileocecal valve (ICV), cecum, and appendix with CT can be challenging. The normal ICV can have many different appearances, depending on cecal distention and mobility, whether the valve is open or closed, and inherent variable morphologic characteristics. In addition, flat cecal lesions are difficult to detect, and larger masses are sometimes mistaken for the ICV or residual stool. Familiarity with the typical appearances of the normal anatomy and various pathologic conditions of the gastrointestinal tract on two- and three-dimensional cross-sectional images is useful in making the correct diagnosis.

© RSNA, 2007