Characteristics and associated risk factors of diverticular disease assessed by magnetic resonance imaging in subjects from a Western general population

Storz, Corinna; Rothenbacher, Theresa; Rospleszcz, Susanne; Linseisen, Jakob; Messmann, Helmut; Cecco, Carlo N. De; Machann, Jürgen; Lorbeer, Roberto; Kiefer, Lena S.; Wintermeyer, Elke; Rado, Sophia D.; Nikolaou, Konstantin; Elser, Stefanie; Rathmann, Wolfgang; Reiser, Maximilian; Peters, Annette; Schlett, Christopher L.; Bamberg, Fabian

doi:10.1007/s00330-018-5687-5

Cited by 12 publications

(29 citation statements)

References 42 publications

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“…Our study found a strong link between the presence of asymptomatic advanced diverticular disease and constitutional risk factors, e. g. increased BMI, VAT, and hepatic PDFF. As we previously showed, advanced diverticular disease is also associated with age and more interestingly, participants with left-sided diverticular disease have a higher BMI and are older [10]. Overall, our findings lead to the presumption that advanced diverticular disease in left-▶ Presented are Odds Ratios (OR) and 95 % confidence intervals (CI) from a logistic regression model with outcome diverticular disease.…”

Section: Discussionsupporting

confidence: 62%

“…Various large-scale studies utilizing colonoscopy or computed tomography found an increasing prevalence of diverticulosis, due to multiple risk factors accelerating the development of diverticu-lar disease [1,2,9]. Previously, we demonstrated that magnetic resonance imaging (MRI) is a valid, reproducible, noninvasive modality for the assessment of diverticular disease and our initial results showed that asymptomatic diverticular disease is a common burden on healthcare system in the Western general population [10].…”

Section: Introductionmentioning

confidence: 79%

“…There is a large body of evidence that the prevalence of colonic diverticula increases with age and in Western populations most of the colonic diverticula are located in the left-sided colonic segments [1,2,10,16,20]. A classic hypothesis assumes a link between dietary habits (e. g. low-fiber intake) as well as high intraluminal pressure leading to herniation of the mucosa in weak seg- ments of the colonic muscular layers [21].…”

Section: Discussionmentioning

confidence: 99%

“…The assessment and graduation system of diverticular disease was reported in detail elsewhere [10]. A T1-weighted 2-point isotropic VIBE-Dixon sequence (slice thickness: 1.7 mm, spatial resolution: 1.7 × 1.7 mm 2 , field of view: 488 × 717 mm using a 256 × 256 mm matrix, repetition time: 4.06 ms, echo time: 1.26; 2.49 ms, 9°flip angle) of the abdomen was employed for the assessment and evaluation of diverticular disease by counting diverticula potentially present in each colonic segment [10].…”

Section: Assessment Of Diverticular Diseasementioning

confidence: 99%

“…Diverticular disease was classified by a graded-scale to define the extent of diverticular disease, derived from the three-point quantitative scale used in a CT colonography study by de Cecco et al [10,16]: grade 1: no diverticular disease (no diverticula in all colonic segments), grade 2: mild diverticular disease (1-5 diverticula in at least one colonic segment), grade 3: advanced diverticular disease (≥ 6 diverticula in at least one colonic segment) [10]. A representative example of a participant with diverticular disease is provided in ▶ Fig.…”

Section: Assessment Of Diverticular Diseasementioning

confidence: 99%

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Magnetic Resonance Imaging of Diverticular Disease and its Association with Adipose Tissue Compartments and Constitutional Risk Factors in Subjects from a Western General Population

Storz

Rospleszcz

Askani

et al. 2020

Rofo

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Purpose To determine the association of asymptomatic diverticular disease as assessed by magnetic resonance imaging (MRI) with adipose tissue compartments, hepatic steatosis and constitutional risk factors within a cohort drawn from a Western general population. Materials and Methods Asymptomatic subjects enrolled in a prospective case-control study underwent a 3 Tesla MRI scan, including an isotropic VIBE-Dixon sequence of the entire trunk. The presence and extent of diverticular disease were categorized according to the number of diverticula in each colonic segment in a blinded fashion. The amount of visceral, subcutaneous, and total adipose tissue (VAT, SAT, and TAT) was quantified by MRI. Additionally, the degree of hepatic steatosis, indicated as hepatic proton density fat fraction (hepatic PDFF) was determined using a multi-echo T1w sequence. Constitutional cardiometabolic risk factors were obtained and univariate and multivariate associations were calculated. Results A total of 371 subjects were included in the analysis (58.2 % male, 56.2 ± 9.2 years). Based on MRI, 154 participants (41.5 %) had diverticular disease with 62 cases (17 %) being advanced diverticular disease. Subjects with advanced diverticular disease had a significantly higher body mass index (BMI) (BMI: 29.9 ± 5.1 vs. 27.5 ± 4.6, p < 0.001; respectively). Furthermore, all adipose tissue compartments were increased in subjects with advanced diverticular disease (e. g. VAT: 6.0 ± 2.8 vs. 4.2 ± 2.6 and SAT: 9.2 ± 3.6 vs. 7.8 ± 3.6, all p < 0.001, respectively). Similarly, subjects with advanced diverticular disease had significantly higher hepatic PDFF (4.9 [2.7, 11.4] vs. 6.1 [5.5, 14.6], p = 0.002). Conclusion Advanced diverticular disease is associated with an increased volume of adipose tissue compartments and BMI, which may suggest a metabolic role in disease development. Key Points: Citation Format

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Section: Discussionsupporting

confidence: 62%

Section: Introductionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Assessment Of Diverticular Diseasementioning

confidence: 99%

Section: Assessment Of Diverticular Diseasementioning

confidence: 99%

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Magnetic Resonance Imaging of Diverticular Disease and its Association with Adipose Tissue Compartments and Constitutional Risk Factors in Subjects from a Western General Population

Storz

Rospleszcz

Askani

et al. 2020

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Magnetic Resonance Imaging for the diagnosis and management of acute colonic diverticulitis: a review of current and future use

Jerjen

Zaidi

Chan

et al. 2021

J of Medical Radiation Sci

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Diverticular disease is one of the most common causes of outpatient visits and hospitalisations across Australia, North America and Europe. According to the Gastroenterological Society of Australia (GESA, 2010), approximately 33% of Australians over 45 years of age and 66% over 85 years of age have some form of colonic diverticulosis. Patients with colonic diverticulosis are known to develop subsequent complications such as acute colonic diverticulitis (ACD), and when more than one attack of diverticulitis occurs, there is a 70-90% chance that the individual will experience ongoing problems and recurring infections throughout their lifetime. Medical imaging is fundamental in the diagnosis, treatment and ongoing management of ACD and its complications, with Computed Tomography (CT) identified as the prevailing gold standard in the last few decades. Cross-database searching highlighted a large gap in the literature regarding the effectiveness of Magnetic Resonance Imaging (MRI) as a non-ionising radiation alternative imaging tool for ACD imaging after the mid-2000s, despite ongoing technological advancements in this modality. This narrative review identified 13 key publications (11 primary prospective cohort studies, 1 systematic review and 1 meta-analysis) that evaluate MRI for ACD imaging, of which five were published within the last decade. Several existing MRI protocols are deemed suitable for ACD imaging, and it is recommended they be re-evaluated in larger cohorts. Future studies should consider the rapidly growing technological improvements of MRI, its cost efficiency and its applicability in modern day healthcare settings when addressing ACD management. This is especially important considering the gradual rise in radiation dose among the Australian population attributable to increased CT referrals, alongside increased reporting of ACD cases in younger individuals.

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Incidentalomas, SPEW, and VOMIT—radiological dyspepsia?

Brady

2020

Eur Radiol

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Characteristics and associated risk factors of diverticular disease assessed by magnetic resonance imaging in subjects from a Western general population

Cited by 12 publications

References 42 publications

Magnetic Resonance Imaging of Diverticular Disease and its Association with Adipose Tissue Compartments and Constitutional Risk Factors in Subjects from a Western General Population

Magnetic Resonance Imaging of Diverticular Disease and its Association with Adipose Tissue Compartments and Constitutional Risk Factors in Subjects from a Western General Population

Magnetic Resonance Imaging for the diagnosis and management of acute colonic diverticulitis: a review of current and future use

Incidentalomas, SPEW, and VOMIT—radiological dyspepsia?

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