caa a22 4500 605493383 CHVBK 20210128100520.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00261-015-0448-2 doi (NATIONALLICENCE)springer-10.1007/s00261-015-0448-2 Sigmoid stenosis caused by diverticulitis vs. carcinoma: usefulness of sonographic features for their differentiation in the emergency setting [Elektronische Daten] [Tomás Ripollés, María Martínez-Pérez, Diana Gómez Valencia, José Vizuete, Gregorio Martín] 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. Springer Science+Business Media New York, 2015 Ultrasound nationallicence Diverticulitis nationallicence Cancer nationallicence Colon nationallicence Sigmoid nationallicence Stenosis nationallicence Ripollés Tomás Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain aut Martínez-Pérez María Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain aut Gómez Valencia Diana Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain aut Vizuete José Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain aut Martín Gregorio Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/7(2015-10-01), 2219-2231 0942-8925 40:7<2219 2015 40 261 https://doi.org/10.1007/s00261-015-0448-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-015-0448-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ripollés Tomás Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain aut NATIONALLICENCE 700 1- Martínez-Pérez María Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain aut NATIONALLICENCE 700 1- Gómez Valencia Diana Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain aut NATIONALLICENCE 700 1- Vizuete José Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain aut NATIONALLICENCE 700 1- Martín Gregorio Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/7(2015-10-01), 2219-2231 0942-8925 40:7<2219 2015 40 261