Ileocecal valve: spectrum of normal findings at double-contrast barium enema examination.
OBJECTIVE
To characterize the spectrum of normal findings of the ileocecal valve at double-contrast barium enema examination to allow differentiation between a normal valve and one infiltrated by tumor.


METHODS
A search of radiology and endoscopy files showed 106 patients who underwent double-contrast barium enema examination and colonoscopy. The radiographic images were reviewed by two authors to determine the morphology of the ileocecal valve and to evaluate whether it appeared normal or abnormal. The radiographic data were then correlated with endoscopic and pathologic findings.


RESULTS
The ileocecal valve was visible in 91 (86%) of 106 patients. It was round or ovoid in 71 patients (78%) and triangular in 20 (22%). In the 88 patients with a normal valve at colonoscopy, mean valve height was 1.7 cm, and mean width was 2.8 cm. The valve was smooth in 75 patients (85%) and smoothly lobulated in 13 (15%). The lips of the valve were symmetric in 77 patients (88%) and asymmetric in 11 (12%). All 87 patients with a normal valve at double-contrast barium enema examination had a normal valve at colonoscopy, whereas the two patients with a valve suspicious for tumor at barium enema examination had neoplasms (one carcinoma and one villous adenoma) at colonoscopy.


CONCLUSIONS
The ileocecal valve may show a spectrum of normal findings at double-contrast barium enema examination and may appear as a round, ovoid, or triangular structure with a maximal height of nearly 4 cm. The valve may be large, asymmetric, or smoothly lobulated, even in the absence of tumor.
El-Amin
Lisa C
LC
Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104, USA.
Levine
Marc S
MS
Rubesin
Stephen E
SE
Shah
Janak N
JN
Kochman
Michael L
ML
Laufer
Igor
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D003113:Colonoscopy; D003287:Contrast Media; D004733:Enema; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis; D007080:Ileocecal Valve / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011859:Radiography
D003287:Contrast Media; D001466:Barium Sulfate