Abstract：
OBJECTIVE: To evaluate the usefulness of unenhanced CT added to the portal venous phase in the diagnostic accuracy of acute colonic diverticulitis/sigmoiditis.
METHODS: Between January 1st and December 31st, 2020, all consecutive adult patients referred to the radiology department for clinical suspicion of acute colonic diverticulitis/sigmoiditis were retrospectively screened. To be included, patients must have undergone a CT with both unenhanced (UCT) and contrast-enhanced portal venous phase CT (CECT). CT examinations were assessed for features of diverticulitis, complications, differential diagnosis and incidental findings using UCT + CECT association, medical management, and follow-up as the reference. Radiation doses were recorded on our image archiving system and assessed.
RESULTS: Of the 114 patients included (mean age was 67±18 years; 60% were female), 46 had acute colonic diverticulitis/sigmoiditis. No diagnosis of sigmoiditis/diverticulitis, complication or differential diagnosis was missed with the CECT alone. Apart from diverticulitis, only one 2 mm meatal urinary microlithiasis was missed with no impact on patient management. The confidence level in diagnosis was not increased by UCT. The average DLP of CECT was 450 mGy.cm, and 382 mGy.cm for UCT. The use of a single-phase CECT acquisition allowed a reduction of 45.9% of the irradiation.
CONCLUSIONS: Unenhanced CT is not necessary for patients addressed with clinical suspicion of acute colonic diverticulitis/sigmoiditis, and CECT alone protocol must be used.
METHODS: Between January 1st and December 31st, 2020, all consecutive adult patients referred to the radiology department for clinical suspicion of acute colonic diverticulitis/sigmoiditis were retrospectively screened. To be included, patients must have undergone a CT with both unenhanced (UCT) and contrast-enhanced portal venous phase CT (CECT). CT examinations were assessed for features of diverticulitis, complications, differential diagnosis and incidental findings using UCT + CECT association, medical management, and follow-up as the reference. Radiation doses were recorded on our image archiving system and assessed.
RESULTS: Of the 114 patients included (mean age was 67±18 years; 60% were female), 46 had acute colonic diverticulitis/sigmoiditis. No diagnosis of sigmoiditis/diverticulitis, complication or differential diagnosis was missed with the CECT alone. Apart from diverticulitis, only one 2 mm meatal urinary microlithiasis was missed with no impact on patient management. The confidence level in diagnosis was not increased by UCT. The average DLP of CECT was 450 mGy.cm, and 382 mGy.cm for UCT. The use of a single-phase CECT acquisition allowed a reduction of 45.9% of the irradiation.
CONCLUSIONS: Unenhanced CT is not necessary for patients addressed with clinical suspicion of acute colonic diverticulitis/sigmoiditis, and CECT alone protocol must be used.
摘要：
目的：评估在门静脉期增加未增强CT在诊断急性结肠憩室炎/乙状结肠炎的准确性中的有用性。
方法：1月1日至12月31日，2020年，回顾性筛查所有因临床怀疑急性结肠憩室炎/乙状结肠炎而转诊至放射科的连续成年患者。要包括在内，患者必须同时接受CT检查,同时接受未增强(UCT)和对比增强门静脉期CT(CECT)检查.CT检查评估憩室炎的特征，并发症,使用UCT+CECT关联的鉴别诊断和偶然发现，医疗管理,和后续作为参考。将辐射剂量记录在我们的图像存档系统上并进行评估。
结果：在纳入的114例患者中（平均年龄为67±18岁；60％为女性），46例患有急性结肠憩室炎/乙状结肠炎。没有诊断乙状结肠炎/憩室炎，仅CECT就错过了并发症或鉴别诊断.除了憩室炎,仅1例2毫米的尿路微石症被漏诊,对患者管理无影响.UCT没有提高诊断的置信水平。CECT的平均DLP为450mGy。cm,和382MGY。厘米为UCT。使用单相CECT采集可以减少45.9％的辐照。
结论：对于临床怀疑急性结肠憩室炎/乙状结肠炎的患者，不需要增强CT，必须使用CECT单独协议。
方法：1月1日至12月31日，2020年，回顾性筛查所有因临床怀疑急性结肠憩室炎/乙状结肠炎而转诊至放射科的连续成年患者。要包括在内，患者必须同时接受CT检查,同时接受未增强(UCT)和对比增强门静脉期CT(CECT)检查.CT检查评估憩室炎的特征，并发症,使用UCT+CECT关联的鉴别诊断和偶然发现，医疗管理,和后续作为参考。将辐射剂量记录在我们的图像存档系统上并进行评估。
结果：在纳入的114例患者中（平均年龄为67±18岁；60％为女性），46例患有急性结肠憩室炎/乙状结肠炎。没有诊断乙状结肠炎/憩室炎，仅CECT就错过了并发症或鉴别诊断.除了憩室炎,仅1例2毫米的尿路微石症被漏诊,对患者管理无影响.UCT没有提高诊断的置信水平。CECT的平均DLP为450mGy。cm,和382MGY。厘米为UCT。使用单相CECT采集可以减少45.9％的辐照。
结论：对于临床怀疑急性结肠憩室炎/乙状结肠炎的患者，不需要增强CT，必须使用CECT单独协议。
