Spectrum of normal and abnormal CT appearances of the ileocecal valve and cecum with endoscopic and surgical correlation

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.