Results of this feasibility study suggest that CAD for CT colonography significantly improves per-polyp detection for less-experienced readers.

The computed tomographic (CT) appearance of urachal carcinoma in ten patients was studied and compared with the pathologic findings. Magnetic resonance images were available in one case. All tumors were mucinous adenocarcinomas; four were solid, three were cystic, and three were mixed. The tumor had a characteristic location along the expected midline course of the urachus directly behind the anterior abdominal wall. The main tumor mass was supravesical in eight patients. Seven tumors contained calcification. CT correctly depicted bladder wall involvement and supravesical extent of tumor in all cases. CT provided incorrect information about invasion of the perivesical fat in three patients and about bladder mucosal invasion in two patients.

OBJECTIVE.Idiopathic localized dilatation of the ileum is a rare entity characterized by a sharply demarcated segmental dilatation of the small bowel that is in line with the and In one, the lesion was seen on a barium enema with reflux into the ileum. The mean age of patients was 52 years. In seven cases, pathologic correlation was available.In the other two patients, long-term clinical follow-up and repeat studies confirmed the diagnosis. Resected specimens showed a thin but otherwise normal wall with normal ganglion cells and nerve plexuses. Ulceration was noted in six of the seven resected cases. Two cases contained heterotopic gastric mucosa. Gi bleeding and/or anemia was the most common (77%) presenting symptom. Abdominal pain and/or obstruction was present in slightly less than half the patients (44%).RESULTS. Lesions were 6-21 cm long and 4-13 cm wide, and all were located in the ileum. The dilated segments were bilobate in three cases, multilobate in three, spherical in two, and tubular in the other. The dilated area was always in line with the long axis of the bowel, not projecting to the side. No surrounding masses were seen. Except in three patients in whom ulcers were noted, the mucosa was normal.CONCLUSION. Idiopathic localized dilatation of the ileum should be suspected whenever a sharply demarcated area of lobulated small bowel dilatation is seen in a middle-aged patient with occult Gi bleeding. The axial orientation distinguishes this condition from small bowel diverticula (including Meckel's). The lack of surrounding mass, mucosal irregularity, hypermotility, or fistulae help differentiate it from other causes of small bowel dilatation.