Acute Colonic Diverticulitis: CT Findings, Classifications, and a Proposal of a Structured Reporting Template.
Francesco TiralongoStefano Di PietroDario MilazzoSebastiano GaliotoDavide Giuseppe CastiglioneCorrado InìPietro Valerio FotiCristina MosconiFrancesco GiurazzaMassimo VenturiniGuido Nicola ZanghìStefano PalmucciAntonio BasilePublished in: Diagnostics (Basel, Switzerland) (2023)
Acute colonic diverticulitis (ACD) is the most common complication of diverticular disease and represents an abdominal emergency. It includes a variety of conditions, extending from localized diverticular inflammation to fecal peritonitis, hence the importance of an accurate diagnosis. Contrast-enhanced computed tomography (CE-CT) plays a pivotal role in the diagnosis due to its high sensitivity, specificity, accuracy, and interobserver agreement. In fact, CE-CT allows alternative diagnoses to be excluded, the inflamed diverticulum to be localized, and complications to be identified. Imaging findings have been reviewed, dividing them into bowel and extra-intestinal wall findings. Moreover, CE-CT allows staging of the disease; the most used classifications of ACD severity are Hinchey's modified and WSES classifications. Differential diagnoses include colon carcinoma, epiploic appendagitis, ischemic colitis, appendicitis, infectious enterocolitis, and inflammatory bowel disease. We propose a structured reporting template to standardize the terminology and improve communication between specialists involved in patient care.
Keyphrases
- contrast enhanced
- computed tomography
- dual energy
- diffusion weighted
- magnetic resonance imaging
- image quality
- magnetic resonance
- positron emission tomography
- liver failure
- diffusion weighted imaging
- high resolution
- respiratory failure
- ulcerative colitis
- public health
- emergency department
- oxidative stress
- lymph node
- drug induced
- intensive care unit
- risk factors
- mass spectrometry
- molecularly imprinted
- structural basis
- fluorescence imaging