Colonic Diverticulitis Location Affects the Diagnostic Accuracy of Point-of-Care Ultrasound: A Multicenter, 10-Year Study

Huang, Chun‐Hsiang; Liu, Kao–Lang; Lim, Zi-Jiang; Sung, Chih-Wei; Wang, Hsiu-Po; Chen, I-Chung; Lien, Wan-Ching; Huang, Chengming

doi:10.1016/j.ultrasmedbio.2023.03.010

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…Как показал ряд исследований, диагноз воспалительных осложнений ДБ, поставленный лишь на основании клинической картины, точен только у 43-68% пациентов [5][6][7]. На сегодняшний день общепризнано, что компьютерная томография (КТ) наряду с ультразвуковым исследованием (УЗИ) является методом выбора для оценки распространенности и выраженности воспалительных изменений при ДБ [8][9][10][11][12][13]. Как показал метаанализ, проведенный W. Lameris и соавт., КТ обладает высокой чувствительностью (94%) и специфичностью (99%) в выявлении воспалительных осложнений ДБ и нередко позволяет получить дополнительную информацию о клинически важных патологических изменениях в других органах брюшной полости и забрюшинного пространства [10].…”

Section: Introductionunclassified

Prognostic possibilities of CT in the diagnosis of chronic inflammatory complications of diverticular disease

Belov,

Zarodnyuk,

Moskalev

et al. 2023

Medicinskaâ vizualizaciâ

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Objective: to determine the diagnostic effectiveness of computed tomography (CT) in predicting the course of the disease in patients with chronic inflammatory complications of diverticular disease (DD).Material and methods. The study included 70 patients with a complicated course of colon diverticular disease in the phase of exacerbation of the chronic inflammatory process. All patients underwent CT of the abdominal cavity with intravenous contrast to assess the type and severity of inflammatory changes in the colon and surrounding tissues in the area of localization of diverticula. All patients received conservative treatment and were monitored as part of the ongoing study for 12 months from the moment of initial treatment at the Center. Surgical intervention due to the ineffectiveness of conservative therapy or the recurrence of the inflammatory process during the established follow-up period was considered as an unfavorable outcome of the disease (42/60%). The positive effect of drug therapy without signs of a return of the clinical picture of inflammation within 12 months was considered as a favorable outcome (28/40%). A statistical analysis of CT signs of inflammatory changes in various DD outcomes was performed to identify prognostic CT parameters.Results. Statistically significant differences were revealed between the severity of inflammatory changes according to CT data for different outcomes of the disease. In the favorable outcome group, the main part (23/28.82%) were patients with diverticulitis, in the unfavorable outcome group, 2/3 of patients (29/42.64%) were diagnosed with pericolic infiltrates, including abscesses/cavities, and colon fistulas. It was found that the thickness of the intestinal wall, the extent of inflammatory changes in the intestinal wall, the extent of inflammatory infiltration of pericolic fiber, the symptom of “centipede”, the accumulation of fluid in the pericolic region statistically significantly differed with different outcomes of chronic inflammatory complications of diverticular disease. Мultivariate Cox proportional hazard model revealed two main predictors of the onset of an unfavorable outcome – thickening of the intestinal wall and the presence of fluid in the pericolic region. Thickening of the intestinal wall at values equal to or greater than 0,6 cm increased the risk of an unfavorable outcome by 4.69 times, and the presence of fluid by 4.52 times.Conclusion. The use in clinical practice of the revealed CT predictors of the onset of an unfavorable outcome in chronic inflammatory complications of DB can serve as one of the factors for deciding on elective surgery in this category of patients.

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Section: Introductionunclassified

Prognostic possibilities of CT in the diagnosis of chronic inflammatory complications of diverticular disease

Belov,

Zarodnyuk,

Moskalev

et al. 2023

Medicinskaâ vizualizaciâ

View full text Add to dashboard Cite

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

Belov,

Zarodnyuk,

Trubacheva

et al. 2023

Koloproktologiâ

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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.

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Colonic Diverticulitis Location Affects the Diagnostic Accuracy of Point-of-Care Ultrasound: A Multicenter, 10-Year Study

Cited by 2 publications

References 29 publications

Prognostic possibilities of CT in the diagnosis of chronic inflammatory complications of diverticular disease

Prognostic possibilities of CT in the diagnosis of chronic inflammatory complications of diverticular disease

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

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