Diverticular disease severity score based on CT colonography.
Eur Radiol
; 23(10): 2723-9, 2013 Oct.
Article
em En
| MEDLINE
| ID: mdl-23660775
ABSTRACT
OBJECTIVE:
We propose a diverticular disease severity score (DDSS) based on CT colonography (CTC) findings.METHODS:
Seventy-nine patients (62 ± 14.5 years) underwent CTC after recovering from an episode of acute diverticulitis. Two independent readers classified each case using a four-point scale (DDSS), based on maximum sigmoid colon wall thickness (MSCWT) and minimum lumen diameter at CTC 1 = MSCWT <3 mm, lumen diameter ≥15 mm; 2 = MSCWT 3-8 mm, lumen diameter ≥5 mm; 3 = MSCWT ≥8 mm, lumen diameter ≥5 mm; 4 = MSCWT ≥8 mm, lumen diameter <5 mm. Intra- and interobserver reproducibility was evaluated. Of 79 patients, 32 (40 %) underwent surgery after CTC; MSCWT was directly measured on the pathological specimen.RESULTS:
Intra- and interobserver reproducibility of DDSS were almost perfect (k = 0.90-0.84). DDSS significantly correlated with the probability of surgery (P = 0.001). After surgery, histopathology revealed acute/chronic diverticular inflammation only in 29 cases, and superimposed sigmoid cancer (n = 2) or Crohn's disease (n = 1) in 3 patients with a DDSS of 4. MSCWT at histopathology correlated with DDSS (P = 0.008).CONCLUSION:
DDSS is highly reproducible and correlates with pathological MSCWT. Nearly 1 in 3 patients with a DDSS of 4 had significant superimposed histopathology. CTC with DDSS can provide colorectal surgeons with valuable information. KEY POINTS ⢠A diverticular disease severity score (DDSS) based on CT colonography is proposed. ⢠This DDSS is based on sigmoid colon wall thickness and lumen diameter. ⢠High scores may be associated with relevant coexisting lesions. ⢠A CTC-based DDSS may influence therapeutic decision-making.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Índice de Gravidade de Doença
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Algoritmos
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Interpretação de Imagem Radiográfica Assistida por Computador
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Colonografia Tomográfica Computadorizada
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Doença Diverticular do Colo
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Aspecto:
Patient_preference
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur Radiol
Ano de publicação:
2013
Tipo de documento:
Article