TY - JOUR
T1 - Prognostic Value of the Diverticular Disease Severity Score Based on CT Colonography
T2 - Follow-up in Patients Recovering from Acute Diverticulitis
AU - Flor, Nicola
AU - Maconi, Giovanni
AU - Sardanelli, Francesco
AU - Lombardi, Maria Antonietta
AU - Colombo, Bernardo
AU - Di Leo, Giovanni
AU - Falleni, Monica
AU - Cornalba, Gianpaolo
AU - Pickhardt, Perry J.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Rationale and Objectives: To assess the prognostic value of a diverticular disease severity score (DDSS) based on computed tomography colonography (CTC) after acute diverticulitis (AD). Materials and Methods: Of 252 patients who had an AD episode, we finally selected 46 patients who underwent both conventional CT at the acute event and CTC after 9 ± 7 weeks. Of these 46 patients, 17 underwent elective surgery after CTC. Disease severity was assessed with a 0-4 modified Hinchey CT-based score and a 1-4 CTC-based DDSS. A phone survey was performed 27 months later (range 4-52) for the 29 patients not surgically treated. Results: Significant correlation was found between CTC-based DDSS and clinical follow-up (P = 0.022) or elective surgery (P = 0.007), but not between clinical follow-up and CT-based score, extraluminal gas, C-reactive protein serum level, age, gender, or first versus recurrent AD episode. CTC demonstrated relevant additional findings in five of 46 (11%) patients: two AD complications (enterocolic and enterotubal fistulae), two colon cancers, and one extracolonic (lung) cancer. Conclusion: sThe CTC-based DDSS showed a prognostic value and correlated with the risk of undergoing surgery, and clinically relevant additional findings were found in more than 10% of patients. CTC could be the preferred test in patients recovering after AD.
AB - Rationale and Objectives: To assess the prognostic value of a diverticular disease severity score (DDSS) based on computed tomography colonography (CTC) after acute diverticulitis (AD). Materials and Methods: Of 252 patients who had an AD episode, we finally selected 46 patients who underwent both conventional CT at the acute event and CTC after 9 ± 7 weeks. Of these 46 patients, 17 underwent elective surgery after CTC. Disease severity was assessed with a 0-4 modified Hinchey CT-based score and a 1-4 CTC-based DDSS. A phone survey was performed 27 months later (range 4-52) for the 29 patients not surgically treated. Results: Significant correlation was found between CTC-based DDSS and clinical follow-up (P = 0.022) or elective surgery (P = 0.007), but not between clinical follow-up and CT-based score, extraluminal gas, C-reactive protein serum level, age, gender, or first versus recurrent AD episode. CTC demonstrated relevant additional findings in five of 46 (11%) patients: two AD complications (enterocolic and enterotubal fistulae), two colon cancers, and one extracolonic (lung) cancer. Conclusion: sThe CTC-based DDSS showed a prognostic value and correlated with the risk of undergoing surgery, and clinically relevant additional findings were found in more than 10% of patients. CTC could be the preferred test in patients recovering after AD.
KW - Abdominal CT
KW - Acute diverticulitis
KW - Colon
KW - CT colonography
KW - Diverticular disease
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U2 - 10.1016/j.acra.2015.08.022
DO - 10.1016/j.acra.2015.08.022
M3 - Article
AN - SCOPUS:84948709598
VL - 22
SP - 1503
EP - 1509
JO - Academic Radiology
JF - Academic Radiology
SN - 1076-6332
IS - 12
ER -