HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Pickhardt, P. J. Articles by Heise, C. P. Search for Related Content PubMed PubMed Citation Articles by Pickhardt, P. J. Articles by Heise, C. P. Related Collections Oncologic Imaging Computed Tomography Gastrointestinal Radiology Related Article

Evaluation of Submucosal Lesions of the Large Intestine

Part 1. Neoplasms¹

¹ From the Department of Radiology (P.J.P., D.H.K.), Section of Gastroenterology and Hepatology (D.V.G.), and Department of Surgery (C.P.H.), University of Wisconsin Medical School, 600 Highland Ave, E3/311 Clinical Science Center, Madison, WI 53792-3252; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (C.O.M.); and the Department of Gastroenterology, Portsmouth Naval Hospital, Portsmouth, Va (G.M.A.). Recipient of a Certificate of Merit award for an education exhibit at the 2006 RSNA Annual Meeting. Received February 20, 2007; revision requested March 23 and received May 7; accepted May 10. P.J.P. is a consultant with Viatronix, Medicsight, and C.B. Fleet; D.H.K. is a speaker with Viatronix and Medicsight; all remaining authors have no financial relationships to disclose. Address correspondence to P.J.P. (e-mail: pj.pickhardt{at}hosp.wisc.edu).

At luminal evaluation of the large intestine, any masslike protrusion that is covered by normal mucosa, whether the underlying process is intramural or extramural in origin, may be reported as a submucosal lesion. The full characterization of submucosal lesions may be difficult with optical colonoscopy alone, and endoscopic biopsy is often nondiagnostic. Cross-sectional radiologic imaging studies allow evaluation of the entire thickness of the bowel wall and surrounding tissues and often provide additional information with regard to lesion origin, internal composition, and extent of disease. Likewise, it may be difficult to distinguish submucosal lesions from mucosal polyps on radiologic images, and optical colonoscopy may provide complementary information about superficial submucosal soft-tissue lesions that are detected at computed tomographic (CT) colonography or barium imaging. Depending on the specific clinical situation, colonoscopy, CT colonography, transrectal ultrasonography, and magnetic resonance imaging all may play an important role in the diagnostic evaluation of submucosal lesions of the large intestine. It is important that radiologists be familiar with the multimodality imaging appearances of such entities so that neoplasms—especially those that are malignant—can be accurately identified and characterized and effectively managed.

© RSNA, 2007

Related Article

Evaluation of Submucosal Lesions of the Large Intestine: Part 2. Nonneoplastic Causes

Perry J. Pickhardt, David H. Kim, Christine O. Menias, Deepak V. Gopal, Glen M. Arluk, and Charles P. Heise
RadioGraphics 2007 27: 1693-1703. [Abstract] [Full Text] [PDF]