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Suspected Acute Colon Diverticulitis: Imaging with Low-Dose Unenhanced Multi–Detector Row CT¹

¹ From the Department of Radiology, CHU de Charleroi (CHUC), Charleroi, Belgium (D.T., P.B., O.A., S.S.); Department of Gastroenterology, Hôpital Ambroise Paré, Mons, Belgium (I.P.); Statistical Unit, Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire, Université Libre de Bruxelles, Brussels, Belgium (V.D.M.); and Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium (P.A.G.). Received August 17, 2004; revision requested October 28; revision received November 17; accepted December 30. Address correspondence to D.T., Department of Radiology, RHMS Clinique Louis Caty, 136 rue Louis Caty, B-7331-Baudour, Belgium (e-mail: denis.tack{at}skynet.be).

View larger version (157K): [in a new window]   Figure 1a. Transverse multi–detector row CT scans (4 x 2.5-mm collimation, 120 kVp) obtained at the level of the sigmoid colon in a 41-year-old man (body mass index, 26.7 kg/m2) with acute colon diverticulitis. All readers interpreted low- and standard-dose scans as low-grade acute diverticulitis of sigmoid colon. (a) Unenhanced low-dose scan acquired at 30 mAs preset and (b) contrast-enhanced standard-dose scan acquired at 120 mAs preset show fat stranding (arrow) around the colon.

View larger version (155K): [in a new window]   Figure 1b. Transverse multi–detector row CT scans (4 x 2.5-mm collimation, 120 kVp) obtained at the level of the sigmoid colon in a 41-year-old man (body mass index, 26.7 kg/m2) with acute colon diverticulitis. All readers interpreted low- and standard-dose scans as low-grade acute diverticulitis of sigmoid colon. (a) Unenhanced low-dose scan acquired at 30 mAs preset and (b) contrast-enhanced standard-dose scan acquired at 120 mAs preset show fat stranding (arrow) around the colon.

View larger version (18K): [in a new window]   Figure 2. Graph shows intrareader agreement ( ± ASE) at low-dose unenhanced multi–detector row CT for signs of diverticulitis, overall diagnosis of diverticulitis, alternative diagnoses, and diverticulitis severity grading by readers 1 (), 2 (), 3 (), and 4 ().

View larger version (22K): [in a new window]   Figure 3. Graph shows interreader agreements ( ± ASE) at low-dose unenhanced multi–detector row CT for signs of diverticulitis, overall diagnosis of diverticulitis, alternative diagnoses, and diverticulitis severity grading. Agreements are shown between readers 1 and 2 (), between readers 1 and 3 (), between readers 1 and 4 (), between readers 2 and 3 (), between readers 2 and 4 (), and between readers 3 and 4().

View larger version (22K): [in a new window]   Figure 4. Graph shows interreader agreements ( ± ASE) at standard-dose contrast-enhanced multi–detector row CT for signs of diverticulitis, overall diagnosis of diverticulitis, alternative diagnoses, and diverticulitis severity grading. Agreements are shown between readers 1 and 2 (), between readers 1 and 3 (), between readers 1 and 4 (), between readers 2 and 3 (), between readers 2 and 4 (), and between readers 3 and 4().