Value of computed tomography and abdominal ultrasound for chronic inflammatory complications of diverticular disease

D. M. Belov, I. Zarodnyuk, Y. L. Trubacheva, A. I. Moskalev, O. Maynovskaya
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Abstract

Aim: to evaluate the diagnostic value of computed tomography (CT) and abdominal ultrasound (US) for chronic inflammatory complications in patients with diverticular disease (DD).Patients and Methods: the prospective cohort study included 50 patients with complicated DD. All patients underwent preoperative abdominal CT with intravenous contrast and abdominal US, with further elective bowel resection. The results of CT and ultrasound were compared with morphology of the removed specimens.Results: the sensitivity and specificity for chronic diverticulitis was 66.7% and 95.7% for CT and 100.0% and 95.7% for US. For chronic pericolic abdominal mass it was 94.8% and 90.9% for CT, 94.8% and 100.0% for US; for abdominal abscesses/cavities it was 87.5% and 96.2% for CT and 91.6% and 100.0% for US; for diverticular fistulas it was 87.5% and 100.0% for CT and 87.5% and 100.0% for US. No significant differences were obtained between two diagnostic modalities. A high level of consistency (κ-coefficient 0.71) of CT and US for the diagnosis of inflammatory complications of DD was found. Conclusion: CT and US have a similar high diagnostic value for chronic inflammatory complications of DD. Each of them can be used as a single diagnostic modality or both depending on the clinical case.
计算机断层扫描和腹部超声波对憩室疾病慢性炎症并发症的价值
目的:评估计算机断层扫描(CT)和腹部超声波(US)对憩室疾病(DD)患者慢性炎症并发症的诊断价值。患者和方法:这项前瞻性队列研究纳入了50名复杂DD患者。所有患者术前均接受了静脉注射造影剂的腹部 CT 和腹部 US 检查,并进一步接受了选择性肠切除术。结果:CT 对慢性憩室炎的敏感性和特异性分别为 66.7% 和 95.7%,US 为 100.0% 和 95.7%。CT对慢性结肠周围腹部肿块的敏感性和特异性分别为94.8%和90.9%,US为94.8%和100.0%;CT对腹部脓肿/空洞的敏感性和特异性分别为87.5%和96.2%,US为91.6%和100.0%;CT对憩室瘘的敏感性和特异性分别为87.5%和100.0%,US为87.5%和100.0%。两种诊断方式之间无明显差异。发现 CT 和 US 在诊断 DD 炎症并发症方面具有高度一致性(κ系数 0.71)。结论:CT 和 US 对 DD 的慢性炎症并发症具有类似的高诊断价值。根据临床病例的不同,CT 和 US 可分别作为单一诊断方法或同时使用。
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