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Volume 20, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603
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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.

Conclusion

Unenhanced CT is not necessary for patients addressed with clinical suspicion of acute colonic diverticulitis/sigmoiditis, and CECT alone protocol must be used.

© 2024 Dray et al.
This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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2024-01-01
2025-04-06

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/content/journals/cmir/10.2174/0115734056259655240103092901
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Additional Non-contrast CT to Portal Venous Phase is not Relevant for Patients referred for Colonic Diverticulitis or Sigmoiditis Suspicion
Curr. Med. Imaging 20, e15734056259655 (2024); https://doi.org/10.2174/0115734056259655240103092901
/content/journals/cmir/10.2174/0115734056259655240103092901
/content/journals/cmir/10.2174/0115734056259655240103092901
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  • Article Type:     Research Article
Keyword(s): Colonic diverticulitis; Contrast agent; Contrast-enhanced CT; Portal venous phase; Sigmoid disease; UCT

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