Comparison of non-contrast CT vs. contrast-enhanced CT with both intravenous and rectal contrast application for diagnosis of acute colonic diverticulitis

• Verfasst von: Móré, Dorottya [VerfasserIn]
• Verfasst von: Erdmann, Stella [VerfasserIn]
• Verfasst von: Bischoff, Arved [VerfasserIn]
• Verfasst von: Wagner, Verena [VerfasserIn]
• Verfasst von: Kauczor, Hans-Ulrich [VerfasserIn]
• Verfasst von: Liesenfeld, Lukas [VerfasserIn]
• Verfasst von: Abbasi Dezfouli, Katharina [VerfasserIn]
• Verfasst von: Giannakis, Athanasios [VerfasserIn]
• Verfasst von: Klauß, Miriam [VerfasserIn]
• Verfasst von: Mayer, Philipp [VerfasserIn]
• Titel: Comparison of non-contrast CT vs. contrast-enhanced CT with both intravenous and rectal contrast application for diagnosis of acute colonic diverticulitis
• Titelzusatz: a multireader, retrospective single-center study
• Verf.angabe: Dorottya More, Stella Erdmann, Arved Bischoff, Verena Wagner, Hans-Ulrich Kauczor, Lukas F. Liesenfeld, Katharina Abbasi Dezfouli, Athanasios Giannakis, Miriam Klauss and Philipp Mayer
• E-Jahr: 2025
• Jahr: January 2025
• Umfang: 13 S.
• Illustrationen: Illustrationen
• Fussnoten: Gesehen am 04.04.2025 ; Online veröffentlicht: 26. Dezember 2024
• Titel Quelle: Enthalten in: Diagnostics
• Ort Quelle: Basel : MDPI, 2011
• Jahr Quelle: 2025
• Band/Heft Quelle: 15(2025), 1, Artikel-ID 29, Seite 1-13
• ISSN Quelle: 2075-4418
• DOI: doi:10.3390/diagnostics15010029
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: colonic diverticulitis
• Sach-SW: computed tomography
• Sach-SW: COMPUTED-TOMOGRAPHY
• Sach-SW: contrast enema
• Sach-SW: DIFFERENTIATION
• Sach-SW: GUIDELINES
• Sach-SW: HELICAL CT
• Sach-SW: MANAGEMENT
• Sach-SW: non-contrast computed tomography
• Sach-SW: PROPOSAL
• Sach-SW: RADIOLOGY
• Sach-SW: reader study
• Sach-SW: SOCIETY
• K10plus-PPN: 1919046704

Abstract

Objectives: To evaluate the non-inferiority of non-contrast CT compared to contrast-enhanced CT with both intravenous and rectal contrast application for the diagnosis of acute colonic diverticulitis. Methods: Five readers retrospectively evaluated the non-contrast and contrast-enhanced series of CTs of 205 consecutive patients with clinical suspicion of acute diverticulitis. Two randomized reading sessions, both containing all 205 cases as either contrast-enhanced or non-contrast (1:1) series, were performed with >= 8 weeks washout between them. The non-inferiority margin was set to 0.1. Results: The pooled prevalence (all readers) of diverticulitis was similar for non-contrast CT (63.9%, range: 60.5-65.0%) and contrast-enhanced CT (64.4%, 61.5-67.8%). Non-contrast CT was non-inferior for the diagnosis of diverticulitis (accuracy 0.90 [95% confidence interval: 0.89, 0.92]) compared to contrast-enhanced CT (0.92 [0.90, 0.94]; the difference in accuracy: -0.01 [-0.04, 0.01]) (normal deviate test: p-valueone-sided = 5.20 x 10-6). Sensitivities for perforation and abscess were slightly but significantly lower for the non-contrast CT than for the contrast-enhanced CT (differences: -0.15 [-0.20, -0.05], -0.17 [-0.27, -0.07]), while no differences in accuracies and specificities were observed. Conclusions: Non-contrast CT is non-inferior to contrast-enhanced CT (intravenous and rectal contrast) for the diagnosis of acute colonic diverticulitis. Contrast-enhanced CT is associated with significantly higher sensitivities for the presence of an abscess or perforation.