Title:Additional Non-contrast CT to Portal Venous Phase is not Relevant for Patients
referred for Colonic Diverticulitis or Sigmoiditis Suspicion
Volume: 20
Author(s): Bertille Dray*, Christophe Aubé, Thomas Boishardy, Louis Besnier, Carolina Darii, Marie Bougard and Anita Paisant
Affiliation:
- Department of Radiology, Angers University Hospital, Angers 49100, France
Keywords:
Sigmoid disease, Colonic diverticulitis, Contrast agent, Portal venous phase, Contrast-enhanced CT, UCT.
Abstract:
Objective:
To evaluate the usefulness of unenhanced CT added to the portal venous phase in the diagnostic accuracy of acute colonic
diverticulitis/sigmoiditis.
Methods:
Between January 1st and December 31st, 2020, all consecutive adult patients referred to the radiology department for clinical suspicion of acute
colonic diverticulitis/sigmoiditis were retrospectively screened. To be included, patients must have undergone a CT with both unenhanced (UCT)
and contrast-enhanced portal venous phase CT (CECT). CT examinations were assessed for features of diverticulitis, complications, differential
diagnosis and incidental findings using UCT + CECT association, medical management, and follow-up as the reference. Radiation doses were
recorded on our image archiving system and assessed.
Results:
Of the 114 patients included (mean age was 67±18 years; 60% were female), 46 had acute colonic diverticulitis/sigmoiditis. No diagnosis of
sigmoiditis/diverticulitis, complication or differential diagnosis was missed with the CECT alone. Apart from diverticulitis, only one 2 mm meatal
urinary microlithiasis was missed with no impact on patient management. The confidence level in diagnosis was not increased by UCT. The
average DLP of CECT was 450 mGy.cm, and 382 mGy.cm for UCT. The use of a single-phase CECT acquisition allowed a reduction of 45.9% of
the irradiation.
Conclusion:
Unenhanced CT is not necessary for patients addressed with clinical suspicion of acute colonic diverticulitis/sigmoiditis, and CECT alone protocol
must be used.
