OBJECTIVE: To prospectively assess the diagnostic value of intestinal ultrasound (US) compared to computerized tomography (CT) in differentiating uncomplicated and complicated acute colonic diverticulitis (ACD). MATERIALS AND METHODS: During a period of 14 months patients referred to the department of Radiology with clinical suspicion of ACD underwent an US examination. All confirmed US ACD diagnosis were included and subsequently underwent an emergency abdominal CT, used as gold standard. The WSES (World Society for Emergent Surgery) classification of diverticulitis was used. Diverticulitis was prospectively classified as either uncomplicated or complicated. Sensitivity, specificity, positive predictive value, and negative predictive values of US were evaluated. Before CT scan, the radiologist indicated whether they would have required or not a complementary CT scan, based on US findings. RESULTS: Of the 240 patients included in our study, 71 (29.6%) were Stage 0, 127 (53%) Stage 1A, and 42 (17.5%) were moderate-severe ACD (stages 1B, 2A, 2B, 3 and 4). The sensitivity of US for diagnosing complicated ACD was 84% and specificity of 95.8%. Most patients (24 of 27) misclassified by US as uncomplicated diverticulitis were classified on CT as stage 1A. From the 148 cases in which the radiologist considered CT unnecessary, only 3 of these revealed signs of complicated ACD on CT; none of them required emergency surgery. CONCLUSION: US is an effective technique to differentiate complicated from uncomplicated ACD. Our results suggest that US, may be a valuable alternative to CT for the initial radiologic evaluation in patients with clinical suspicion of ACD.
OBJECTIVE: To prospectively assess the diagnostic value of intestinal ultrasound (US) compared to computerized tomography (CT) in differentiating uncomplicated and complicated acute colonic diverticulitis (ACD). MATERIALS AND METHODS: During a period of 14 months patients referred to the department of Radiology with clinical suspicion of ACD underwent an US examination. All confirmed US ACD diagnosis were included and subsequently underwent an emergency abdominal CT, used as gold standard. The WSES (World Society for Emergent Surgery) classification of diverticulitis was used. Diverticulitis was prospectively classified as either uncomplicated or complicated. Sensitivity, specificity, positive predictive value, and negative predictive values of US were evaluated. Before CT scan, the radiologist indicated whether they would have required or not a complementary CT scan, based on US findings. RESULTS: Of the 240 patients included in our study, 71 (29.6%) were Stage 0, 127 (53%) Stage 1A, and 42 (17.5%) were moderate-severe ACD (stages 1B, 2A, 2B, 3 and 4). The sensitivity of US for diagnosing complicated ACD was 84% and specificity of 95.8%. Most patients (24 of 27) misclassified by US as uncomplicated diverticulitis were classified on CT as stage 1A. From the 148 cases in which the radiologist considered CT unnecessary, only 3 of these revealed signs of complicated ACD on CT; none of them required emergency surgery. CONCLUSION: US is an effective technique to differentiate complicated from uncomplicated ACD. Our results suggest that US, may be a valuable alternative to CT for the initial radiologic evaluation in patients with clinical suspicion of ACD.
Authors: Julius Matthias Weinrich; Peter Bannas; Maxim Avanesov; Franziska Schlichting; Leonie Schmitz; Gerhard Adam; Frank Oliver Henes Journal: AJR Am J Roentgenol Date: 2020-04-22 Impact factor: 3.959
Authors: Samuel J Galgano; Michelle M McNamara; Christine M Peterson; David H Kim; Kathryn J Fowler; Marc A Camacho; Brooks D Cash; Kevin J Chang; Barry W Feig; Kenneth L Gage; Evelyn M Garcia; Avinash R Kambadakone; Angela D Levy; Peter S Liu; Daniele Marin; Courtney Moreno; Jason A Pietryga; Martin P Smith; Stefanie Weinstein; Laura R Carucci Journal: J Am Coll Radiol Date: 2019-05 Impact factor: 5.532
Authors: K Nielsen; M C Richir; T T Stolk; T van der Ploeg; G R H M Moormann; B M Wiarda; W H Schreurs Journal: World J Surg Date: 2014-07 Impact factor: 3.352
Authors: Caroline S Andeweg; Irene M Mulder; Richelle J F Felt-Bersma; Annelies Verbon; Gert Jan van der Wilt; Harry van Goor; Johan F Lange; Jaap Stoker; Marja A Boermeester; Robert P Bleichrodt Journal: Dig Surg Date: 2013-08-20 Impact factor: 2.588
Authors: Wytze Laméris; Adrienne van Randen; Shandra Bipat; Patrick M M Bossuyt; Marja A Boermeester; Jaap Stoker Journal: Eur Radiol Date: 2008-06-04 Impact factor: 5.315
Authors: Tomás Ripollés; Marcos Agramunt; María Jesús Martínez; Salvador Costa; Segundo A Gómez-Abril; José Richart Journal: Eur Radiol Date: 2003-05-22 Impact factor: 5.315
Authors: Adrienne van Randen; Wytze Laméris; H Wouter van Es; Hans P M van Heesewijk; Bert van Ramshorst; Wim Ten Hove; Willem H Bouma; Maarten S van Leeuwen; Esteban M van Keulen; Patrick M Bossuyt; Jaap Stoker; Marja A Boermeester Journal: Eur Radiol Date: 2011-03-02 Impact factor: 5.315
Authors: Massimo Sartelli; Fausto Catena; Luca Ansaloni; Federico Coccolini; Ewen A Griffiths; Fikri M Abu-Zidan; Salomone Di Saverio; Jan Ulrych; Yoram Kluger; Ofir Ben-Ishay; Frederick A Moore; Rao R Ivatury; Raul Coimbra; Andrew B Peitzman; Ari Leppaniemi; Gustavo P Fraga; Ronald V Maier; Osvaldo Chiara; Jeffry Kashuk; Boris Sakakushev; Dieter G Weber; Rifat Latifi; Walter Biffl; Miklosh Bala; Aleksandar Karamarkovic; Kenji Inaba; Carlos A Ordonez; Andreas Hecker; Goran Augustin; Zaza Demetrashvili; Renato Bessa Melo; Sanjay Marwah; Sanoop K Zachariah; Vishal G Shelat; Michael McFarlane; Miran Rems; Carlos Augusto Gomes; Mario Paulo Faro; Gerson Alves Pereira Júnior; Ionut Negoi; Yunfeng Cui; Norio Sato; Andras Vereczkei; Giovanni Bellanova; Arianna Birindelli; Isidoro Di Carlo; Kenneth Y Kok; Mahir Gachabayov; Georgios Gkiokas; Konstantinos Bouliaris; Elif Çolak; Arda Isik; Daniel Rios-Cruz; Rodolfo Soto; Ernest E Moore Journal: World J Emerg Surg Date: 2016-07-29 Impact factor: 5.469