Dark-lumen magnetic resonance colonography in patients with suspected sigmoid diverticulitis: a feasibility study
Tóm tắt
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.
Tài liệu tham khảo
Eastwood M (2003) Colonic diverticula. Proc Nutr Soc 62:31–36
West AB, Losada M (2004) The pathology of diverticulosis coli. J Clin Gastroenterol 38:S11–S16
Shafik A, Ahmed I, Shafik AA, El Sibai O (2004) Diverticular disease: electrophysiologic study and a new concept of pathogenesis. World J Surg 28:411–415
Ochsenkuhn T, Goke B (2002) Pathogenesis and epidemiology of sigmoid diverticulosis. Chirurg 73:665–669
Mimura T, Emanuel A, Kamm MA (2002) Pathophysiology of diverticular disease. Best Pract Res Clin Gastroenterol 16:563–576
Aldoori WH, Giovannucci EL, Rimm EB, Wing AL, Trichopoulos DV, Willett WC (1994) A prospective study of diet and the risk of symptomatic diverticular disease in men. Am J Clin Nutr 60:757–764
Aldoori WH (1997) The protective role of dietary fiber in diverticular disease. Adv Exp Med Biol 427:291–308
Boulos PB (2002) Complicated diverticulosis. Best Pract Res Clin Gastroenterol 16:649–662
Bahadursingh AM, Virgo KS, Kaminski DL, Longo WE (2003) Spectrum of disease and outcome of complicated diverticular disease. Am J Surg 186:696–701
Simpson J, Scholefield JH, Spiller RC (2002) Pathogenesis of colonic diverticula. Br J Surg 89:546–554
Nakaji S, Danjo K, Munakata A et al (2002) Comparison of etiology of right-sided diverticula in Japan with that of left-sided diverticula in the West. Int J Colorectal Dis 17:365–373
Hoffmann P, Layer P (1995) Pathogenesis and pathophysiology of sigmoid diverticulitis. Chirurg 66:1169–1172
Kang JY, Melville D, Maxwell JD (2004) Epidemiology and management of diverticular disease of the colon. Drugs Aging 21:211–228
Schwerk WB, Schwarz S, Rothmund M, Arnold R (1993) Colon diverticulitis: imaging diagnosis with ultrasound-a prospective study. Z Gastroenterol 31:294–300
Werner A, Diehl SJ, Farag-Soliman M, Duber C (2003) Multi-slice spiral CT in routine diagnosis of suspected acute left-sided colonic diverticulitis: a prospective study of 120 patients. Eur Radiol 13:2596–2603
Moll R, Mittelkotter U, Reith HB, Schindler G, Thiede A (2002) Which imaging in case of sigmoid diverticulitis? The value of ultrasound (conventional B-mode in combination with hydrocolonsonography and colour flow Doppler) in comparison to the well-established modalities like contrast enema and helical computer tomography. Zentralbl Chir 127:297–301
Fiocca R, Ceppa P (2003) The diagnostic reliability of endoscopic biopsies in diagnosis colitis. J Clin Pathol 56:321–322
Laghi A, Iannaccone R, Carbone I et al (2003) Detection of colorectal lesions with virtual computed tomographic colonography. Am J Surg 183:124–131
Laghi A, Iannaccone R, Carbone I et al (2002) Computed tomographic colonography (virtual colonoscopy): blinded prospective comparison with conventional colonoscopy for the detection of colorectal neoplasia. Endoscopy 34:441–446
Johnson CD, MacCarty RL, Welch TJ et al (2004) Comparison of the relative sensitivity of CT colonography and double-contrast barium enema for screen detection of colorectal polyps. Clin Gastroenterol Hepatol 2:314–321
So NM, Lam WW, Mann D, Leung KL, Metreweli C (2003) Feasibility study of using air as a contrast medium in MR colonography. Clin Radiol 58:555–559
Saar B, Heverhagen JT, Obst T et al (2000) Magnetic resonance colonography and virtual magnetic resonance colonoscopy with the 1.0-T system: a feasibility study. Invest Radiol 35:521–526
Lauenstein TC, Goehde SC, Ruehm SG, Holtmann G, Debatin JF (2002) MR colonography with barium-based fecal tagging: initial clinical experience. Radiology 223:248–254
Ajaj W, Pelster G, Treichel U et al (2003) Dark lumen magnetic resonance colonography: comparison with conventional colonoscopy for the detection of colorectal pathology. Gut 52:1738–1743
Ajaj W, Lauenstein TC, Pelster G, Goehde SC, Debatin JF, Ruehm SG (2004) MR colonography: How does air compare to water for colonic distension. JMRI 19:216–221
Ajaj WM, Lauenstein TC, Pelster G et al (2005) Magnetic resonance colonography for the detection of inflammatory diseases of the large bowel: quantifying the inflammatory activity. Gut 54:257–263
Hollerweger A, Rettenbacher T, Macheiner P, Brunner W, Gritzmann N (2000) Sigmoid diverticulitis: value of transrectal sonography in addition to transabdominal sonography. AJR Am J Roentgenol 175:1155–1560
Landis SH, Murray T, Bodden S, Wingo PA (1998) Cancer statistics, 1998. CA Cancer J Clin 48:6–29
Parulekar SG (1985) Sonography of colonic diverticulitis. J Ultrasound Med 4:659–666
Gottesman L, Zevon SJ, Brabbee GW, Dailey T, Wichern WA Jr (1984) Peritonitis The use of water-soluble contrast enemas in the diagnosis of acute lower left quadrant peritonitis. Dis Colon Rectum 27:84–88
Wexner SD, Dailey TH (1986) The initial management of left lower quadrant peritonitis. Dis Colon Rectum 29:635–638
Shorthouse AJ, Bartram CI, Eyers AA, Thomson JP (1982) The water soluble contrast enema after rectal anastomosis. Br J Surg 69:714–717
Dachman AH (1996) What are the indications for use of water-soluble contrast agent enemas in colon distension? AJR Am J Roentgenol 166:988
Haynes IG, Goldman M, Silverman SH, Alexander-Williams J, Keighley MR (1986) Water-soluble contrast enema after colonic anastomosis. Lancet I:675–676
Poletti PA, Platon A, Rutschmann O et al (2004) Acute left colonic diverticulitis: can CT findings be used to predict recurrence? AJR Am J Roentgenol 182:1159–1165
Ambrosetti P, Becker C, Terrier F (2002) Colonic diverticulitis: impact of imaging on surgical management-a prospective study of 542 patients. Eur Radiol 12:1145–1149
Lefere P, Gryspeerdt S, Baekelandt M, Dewyspelaere J, van Holsbeeck B (2003) Diverticular disease in CT colonography. Eur Radiol 13:62–74
Schreyer AG, Furst A, Agha AJ et al (2004) Magnetic resonance imaging based colonography for diagnosis and assessment of diverticulosis and diverticulitis. Int J Colorectal Dis 19:474–480
Stefansson T, Ekbom A, Sparen P, Pahlman L (2004) Association between sigmoid diverticulitis and left-sided colon cancer: a nested, population-based, case control study. Scand J Gastroenterol 39:743–747
Chintapalli KN, Chopra S, Ghiatas AA, Esola CC, Fields SF, Dodd GD III (1999) Diverticulitis versus colon cancer: differentiation with helical CT findings. Radiology 210:429–435