Sigmoid stenosis caused by diverticulitis vs. carcinoma: usefulness of sonographic features for their differentiation in the emergency setting

Verfasser / Beitragende:
[Tomás Ripollés, María Martínez-Pérez, Diana Gómez Valencia, José Vizuete, Gregorio Martín]
Ort, Verlag, Jahr:
2015
Enthalten in:
Abdominal Imaging, 40/7(2015-10-01), 2219-2231
Format:
Artikel (online)
ID: 605493383
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024 7 0 |a 10.1007/s00261-015-0448-2  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00261-015-0448-2 
245 0 0 |a Sigmoid stenosis caused by diverticulitis vs. carcinoma: usefulness of sonographic features for their differentiation in the emergency setting  |h [Elektronische Daten]  |c [Tomás Ripollés, María Martínez-Pérez, Diana Gómez Valencia, José Vizuete, Gregorio Martín] 
520 3 |a Objective: To retrospectively evaluate the accuracy of ultrasound as a diagnostic method for differentiating acute diverticulitis from colon cancer in patients with sigmoid colon stenosis. Materials and methods: Ultrasound examinations of 91 consecutive patients with sigmoid stenosis (50 diverticulitis and 41 colon cancers) were reviewed by two trained radiologists. Sixty-five (71%) patients presented with acute abdominal symptoms. Thirteen sonographic criteria retrieved from the literature were evaluated to differentiate benign from malignant strictures. A score including all parameters which showed significant differences between benign vs. malignant was built. Sensitivity, specificity, accuracy, and positive or negative predictive values of each sonographic sign, the overall diagnosis, and sonographic score were calculated. Results: Loss of the bowel wall stratification was the most reliable criteria for the diagnosis of malignancy (92% and 94% of sensitivity and specificity, respectively), and the best inter-radiologist agreement (κ=0.848). Adjacent lymph nodes were the most specific feature (98%) for colon cancer, but its sensitivity was low. Global assessment could differentiate both diseases with high sensitivity (92-94.9%) and specificity (98-100%). Sonographic score >3 enabled differentiation of carcinoma from diverticulitis with 95% sensitivity and 92-94% specificity, with an area under the ROC curve of 0.98-0.987. There were no significant differences in the results between patients with acute and nonacute abdominal symptoms. Conclusion: The combination of several morphological sonographic findings using a score can differentiate most cases of diverticulitis from colon carcinoma in sigmoid strictures. 
540 |a Springer Science+Business Media New York, 2015 
690 7 |a Ultrasound  |2 nationallicence 
690 7 |a Diverticulitis  |2 nationallicence 
690 7 |a Cancer  |2 nationallicence 
690 7 |a Colon  |2 nationallicence 
690 7 |a Sigmoid  |2 nationallicence 
690 7 |a Stenosis  |2 nationallicence 
700 1 |a Ripollés  |D Tomás  |u Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain  |4 aut 
700 1 |a Martínez-Pérez  |D María  |u Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain  |4 aut 
700 1 |a Gómez Valencia  |D Diana  |u Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain  |4 aut 
700 1 |a Vizuete  |D José  |u Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain  |4 aut 
700 1 |a Martín  |D Gregorio  |u Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain  |4 aut 
773 0 |t Abdominal Imaging  |d Springer US; http://www.springer-ny.com  |g 40/7(2015-10-01), 2219-2231  |x 0942-8925  |q 40:7<2219  |1 2015  |2 40  |o 261 
856 4 0 |u https://doi.org/10.1007/s00261-015-0448-2  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
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950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00261-015-0448-2  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Ripollés  |D Tomás  |u Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Martínez-Pérez  |D María  |u Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Gómez Valencia  |D Diana  |u Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Vizuete  |D José  |u Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Martín  |D Gregorio  |u Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Abdominal Imaging  |d Springer US; http://www.springer-ny.com  |g 40/7(2015-10-01), 2219-2231  |x 0942-8925  |q 40:7<2219  |1 2015  |2 40  |o 261