Corinna Storz1, Theresa Rothenbacher1, Susanne Rospleszcz2, Jakob Linseisen2,3, Helmut Messmann4, Carlo N De Cecco5, Jürgen Machann6,7,8, Roberto Lorbeer9, Lena S Kiefer1, Elke Wintermeyer10, Sophia D Rado1, Konstantin Nikolaou1, Stefanie Elser1, Wolfgang Rathmann11, Maximilian F Reiser9, Annette Peters2,12,13,14, Christopher L Schlett15, Fabian Bamberg16. 1. Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler Str. 3, 72076, Tuebingen, Germany. 2. Institute of Epidemiology, Helmholtz Centre Munich, German Research Center for Environmental Health, Neuherberg, Germany. 3. University Center of Health Sciences at Klinikum Augsburg (UNIKA-T), Ludwig Maximilian University of Munich, Augsburg, Germany. 4. Department of Internal Medicine III, Klinikum Augsburg, Augsburg, Germany. 5. Department of Radiology, Medical University of South Carolina, Charleston, SC, USA. 6. Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany. 7. Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tuebingen, Tuebingen, Germany. 8. German Center for Diabetes Research (DZD), Tuebingen, Germany. 9. Department of Radiology, Ludwig Maximilian University Hospital, Munich, Germany. 10. Siegfried Weller Institute for Trauma Research, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany. 11. Department of Biometry and Epidemiology, German Diabetes Center, Düsseldorf, Germany. 12. German Center for Cardiovascular Disease Research (DZHK e.V.), Munich, Germany. 13. Institute for Cardiovascular Prevention, Ludwig Maximilian University-Hospital, Munich, Germany. 14. Chair of Epidemiology, Ludwig Maximilian University, Munich, Germany. 15. Department of Radiology, Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany. 16. Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler Str. 3, 72076, Tuebingen, Germany. fabian.bamberg@uni-tuebingen.de.
Abstract
OBJECTIVES: Diverticular disease represents an increasing pathology and healthcare burden worldwide. Our aim was to study the prevalence, extent and distribution of asymptomatic diverticular disease assessed by magnetic resonance imaging (MRI) in a sample of a Western population. METHODS: Subjects from a population-based cohort study who underwent 3-T MRI were analyzed for the prevalence and extent of diverticula of the colon using an isotropic VIBE-Dixon gradient-echo sequence. The extent of diverticular disease was categorized according to the number of diverticula in each colonic segment. Univariate and adjusted analyses were performed to assess associated characteristics and risk factors. RESULTS: Among 393 subjects included in the analysis (56.4 ± 9.2 years, 57.5% males), 164 (42%) had diverticular disease, with the highest prevalence in the left-sided colonic segments (93% diverticular disease in the descending and sigmoid segment). Subjects with advanced diverticular disease were older (62.1 vs. 54.4 years) and had a higher body mass index (BMI), LDL cholesterol levels and systolic blood pressure (30.2 ± 5.1 vs. 27.8 ± 4.9 kg/m2, 149.8 ± 29.3 vs. 135.2 ± 32.9 mg/dl and 128.2 ± 14.1 vs. 118.4 ± 16.1 mmHg, respectively; all p > 0.003) compared with subjects without diverticular disease. In contrast, no significant correlation could be found for gender, physical activity, smoking status and alcohol consumption (all p > 0.31). Intra-rater reliability was excellent for all colonic segments (intra-class correlation [ICC] = 0.99-1.00), and inter-rater reliability was excellent for left- and right-sided colonic segments (ICC = 0.84-0.97). CONCLUSIONS: These findings provide insights into the disease mechanism of asymptomatic diverticular disease and may help to improve prevention of diverticulosis and its associated complications. KEY POINTS: • Overall prevalence of asymptomatic diverticular disease assessed by MRI was 42%, affecting predominantly the left-sided colon. • Asymptomatic diverticular disease was associated with age and cardiometabolic risk factors. • Magnetic resonance imaging reveals insights into the pathophysiologic mechanism of asymptomatic diverticular disease.
OBJECTIVES:Diverticular disease represents an increasing pathology and healthcare burden worldwide. Our aim was to study the prevalence, extent and distribution of asymptomatic diverticular disease assessed by magnetic resonance imaging (MRI) in a sample of a Western population. METHODS: Subjects from a population-based cohort study who underwent 3-T MRI were analyzed for the prevalence and extent of diverticula of the colon using an isotropic VIBE-Dixon gradient-echo sequence. The extent of diverticular disease was categorized according to the number of diverticula in each colonic segment. Univariate and adjusted analyses were performed to assess associated characteristics and risk factors. RESULTS: Among 393 subjects included in the analysis (56.4 ± 9.2 years, 57.5% males), 164 (42%) had diverticular disease, with the highest prevalence in the left-sided colonic segments (93% diverticular disease in the descending and sigmoid segment). Subjects with advanced diverticular disease were older (62.1 vs. 54.4 years) and had a higher body mass index (BMI), LDL cholesterol levels and systolic blood pressure (30.2 ± 5.1 vs. 27.8 ± 4.9 kg/m2, 149.8 ± 29.3 vs. 135.2 ± 32.9 mg/dl and 128.2 ± 14.1 vs. 118.4 ± 16.1 mmHg, respectively; all p > 0.003) compared with subjects without diverticular disease. In contrast, no significant correlation could be found for gender, physical activity, smoking status and alcohol consumption (all p > 0.31). Intra-rater reliability was excellent for all colonic segments (intra-class correlation [ICC] = 0.99-1.00), and inter-rater reliability was excellent for left- and right-sided colonic segments (ICC = 0.84-0.97). CONCLUSIONS: These findings provide insights into the disease mechanism of asymptomatic diverticular disease and may help to improve prevention of diverticulosis and its associated complications. KEY POINTS: • Overall prevalence of asymptomatic diverticular disease assessed by MRI was 42%, affecting predominantly the left-sided colon. • Asymptomatic diverticular disease was associated with age and cardiometabolic risk factors. • Magnetic resonance imaging reveals insights into the pathophysiologic mechanism of asymptomatic diverticular disease.
Entities:
Keywords:
Colon; Diverticular disease; Epidemiology; Magnetic resonance imaging
Authors: Felix Wittström; Nils Skajaa; Kasper Bonnesen; Lars Pedersen; Ola Ekholm; Lisa Strate; Rune Erichsen; Henrik Toft Sørensen Journal: BMJ Open Date: 2022-02-21 Impact factor: 2.692