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.

Prognostic Value of the Diverticular Disease Severity Score Based on CT Colonography : Follow-up in Patients Recovering from Acute Diverticulitis / N. Flor, G. Maconi, F. Sardanelli, M.A. Lombardi, B.M. Colombo, G. Di Leo, M. Falleni, G. Cornalba, P.J. Pickhardt. - In: ACADEMIC RADIOLOGY. - ISSN 1076-6332. - 22:12(2015 Dec), pp. 1503-1509. [10.1016/j.acra.2015.08.022]

Prognostic Value of the Diverticular Disease Severity Score Based on CT Colonography : Follow-up in Patients Recovering from Acute Diverticulitis

G. Maconi
Secondo
;
F. Sardanelli;M.A. Lombardi;B.M. Colombo;M. Falleni;G. Cornalba
Penultimo
;
2015

Abstract

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.
Abdominal CT; Acute diverticulitis; CT colonography; Colon; Diverticular disease
Settore MED/36 - Diagnostica per Immagini e Radioterapia
Settore MED/08 - Anatomia Patologica
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/334913
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