Diverticular disease in CT colonography

Lefere, Philippe; Gryspeerdt, Stefaan; Baekelandt, Marc; Dewyspelaere, J; Holsbeeck, B Van

doi:10.1007/s00330-003-1973-x

Cited by 48 publications

(27 citation statements)

References 32 publications

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“…Initial studies documented high diagnostic accuracies for both CT colonographyand MRC [19][20][21][22][23][24][25] and has become as an attractive alternative to CC for the detection of colorectal pathologies including diverticulitis [37,38]. Lefere et al [37] examined 160 patients with diverticular disease in CT colonography using CC as standard reference and had found a high accuracy of CT colonography compared to CC.…”

Section: Discussionmentioning

confidence: 97%

Dark-lumen magnetic resonance colonography in patients with suspected sigmoid diverticulitis: a feasibility study

Ajaj¹,

Ruehm

Lauenstein³

et al. 2005

Eur Radiol

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To assess dark-lumen magnetic resonance colonography (MRC) for the evaluation of patients with suspected sigmoid diverticulitis. Forty patients with suspected sigmoid diverticulitis underwent MRC within 72 h prior to conventional colonoscopy (CC). A three-dimensional T1-weighted volumetric interpolated breath-hold examination sequence was acquired after an aqueous enema and intravenous administration of gadolinium-based contrast agents. All MRC data were evaluated by two radiologists. Based on wall thickness and focal uptake of contrast material and pericolic reaction including mesenteric infiltration on T1-weighted sequence the sigmoid colon was assessed for the presence of diverticulitis. MRC classified 17 of the 40 patients as normal with regard to sigmoid diverticulitis. However, CC confirmed the presence of light inflammatory signs in four patients which were missed in MRC. MRC correctly identified wall thickness and contrast uptake of the sigmoid colon in the other 23 patients. In three of these patients false-positive findings were observed, and MRC classified the inflammation of the sigmoid colon as diverticulitis whereas CC and histopathology confirmed invasive carcinoma. MRC detected additionally relevant pathologies of the entire colon and could be performed in cases where CC was incomplete. MRC may be considered a promising alternative to CC for the detection of sigmoid diverticulitis.

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Section: Discussionmentioning

confidence: 97%

Dark-lumen magnetic resonance colonography in patients with suspected sigmoid diverticulitis: a feasibility study

Ajaj¹,

Ruehm

Lauenstein³

et al. 2005

Eur Radiol

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“…Residual stool would cause only false positives if it fulfills the volume and CT-value criteria at all. It would be interesting if the contrast-and volumebased approach improves the detection of masses in diverticular disease [27], which often requires a second scan in a changed position.…”

Section: Limitationsmentioning

confidence: 99%

Automated mass detection in contrast-enhanced CT colonography: an approach based on contrast and volume

et al. 2004

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The purpose of this feasibility study was to design and test an algorithm for automating mass detection in contrast-enhanced CT colonography (CTC). Five patients with known colorectal masses underwent a pre-surgical contrast-enhanced (120 ml volume 1.6 g iodine/s injection rate, 60 s scan delay) CTC in high spatial resolution (16-slice CT: collimation: 16x0.75 mm, tablefeed: 24 mm/0.5 s, reconstruction increment: 0.5 mm). A CT-density- and volume-based algorithm searched for masses in the colonic wall, which was extracted before by segmenting and dilating the colonic air lumen and subtracting the inner air. A radiologist analyzed the detections and causes of false positives. All masses were detected, and false positives were easy to identify. Combining CT density with volume as a cut-off is a promising approach for automating mass detection that should be further refined and also tested in contrast-enhanced MR colonography. More information under http://www.screening.info.

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“…Since the purpose of the study was to evaluate position-related distension and breathing artefacts, segments that were inadequately distended due to pathology (i.e. established diverticular strictures [20], tumour, etc. ), were not taken into account for the evaluation of distension adequacy.…”

Section: Evaluation Of Colonic Distension Breathing Artefacts and Rementioning

confidence: 99%

Supine/left decubitus scanning: a valuable alternative to supine/prone scanning in CT colonography

et al. 2004

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The purpose was to evaluate supine/left decubitus as an alternative to supine/prone scanning in computed tomographic colonography (CT colonography). Fifty patients were randomised to supine/prone, another 50 to supine/left decubitus scanning. Patients were scanned using a single-slice CT scanner. The colon was divided into eight segments. Comparisons of distension, breathing artefacts, residus and polyp detection were made between the two groups as well as between the different positions. Adequate distension was found in approximately 85, 97 and 95% of segments in the supine, prone and left decubitus positions, respectively. Combined scanning increased the percentage of adequate distension to 98.5% for prone-supine and 97.7% for left decubitus-supine scanning ( P<0.0005 compared to supine, P=0.001 compared to left decubitus and P=0.046 compared to prone scanning). Absence of residual material was found in approximately 62.7, 69.7 and 64% of segments in the supine, prone and left decubitus positions, respectively. Combined scanning increased this percentage to approximately 99% for both groups. No significant differences towards distension or residual material were found between combined supine-prone or supine-left decubitus scanning. In the supine-prone group, combined scanning additionally revealed four lesions and improved conspicuity in two cases of stalked polyps. In the supine-left decubitus group, combined scanning additionally revealed two lesions and improved conspicuity in one stalked polyp. There were significantly fewer breathing artefacts with left decubitus scanning than prone scanning ( P=0.005). A strong positive correlation was found between breathing artefacts and the age of patients in both patient groups. Colonic distension and preparation is improved by using supine and prone or supine and left decubitus scanning in combination, with a subsequent improved polyp detection. There were no significant differences between the two scanning protocols. Prone scanning, however, is hampered by breathing artefacts, especially in the elderly. Therefore, supine-left decubitus scanning is considered a valuable alternative to supine-prone scanning for the elderly.

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Diverticular disease in CT colonography

Cited by 48 publications

References 32 publications

Dark-lumen magnetic resonance colonography in patients with suspected sigmoid diverticulitis: a feasibility study

Dark-lumen magnetic resonance colonography in patients with suspected sigmoid diverticulitis: a feasibility study

Automated mass detection in contrast-enhanced CT colonography: an approach based on contrast and volume

Supine/left decubitus scanning: a valuable alternative to supine/prone scanning in CT colonography

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