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Chronic diverticulitis vs. colorectal cancer: findings on CT colonography

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Abstract

Purpose

The purpose of this update article is to evaluate findings on CT colonography in patients with chronic diverticulitis and to compare the findings in patients with colorectal carcinoma.

Materials and methods

Different morphological criteria retrieved from a literature review were retrospectively analyzed in a series of 13 patients with proven chronic diverticulitis. The findings were compared with a series of 10 patients with colorectal carcinoma.

Results

Overall, the findings in chronic diverticulitis resemble the findings in acute diverticulitis. The advantage of virtual CT colonography in differentiating both entities relies in the combination of morphological features previously described on axial computed tomography and double contrast barium enema. The single strongest morphological feature pointing towards the diagnosis of chronic diverticulitis is the presence of diverticula in the affected segment. In the presence of diverticula in the affected segment, a long segment (≥10 cm), thick fascia sign without adenopathies, mild bowel wall thickening, tapered margins, and distorted but preserved mucosal folds are likely to further improve accuracy of diagnosing chronic diverticulitis.

Conclusion

The single strongest morphological sign to differentiate chronic diverticulitis from colorectal cancer is the presence of diverticula in the affected segment.

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Acknowledgments

The authors acknowledge the following colleagues for their help with clinical follow-up of the patients: Leroux K, MD Radiology Department, Ziekenhuis Maas en Kempen, B-3680 Maaseik, Belgium; Ardies Ph, MD Radiology Department, AZ Sint-Jozef, B-2390 Malle, Belgium, Clybauw A, MD Radiology Department, AZ Maria Middelares, B-9050 Gentbrugge, Belgium; Grignard F, MD Radiology Department, Sint-Elizabeth Ziekenhuis, B-9620 Zottegem, Belgium; Louagie A, MD Radiology Department, AZL Algemeen Ziekenhuis Lokeren, B-9160 Lokeren, Belgium; Perdieus D, MD Radiology Department, Imelda Ziekenhuis, B-2820 Bonheiden, Belgium; and Sieleghem D, MD Radiology Department, AZ Sint Blazius, B-9200 Dendermonde, Belgium. The authors also acknowledge Fieuws S, Ir, Biostatistical Centre, Katholieke Universiteit Leuven, Kapucijnenvoer 35, B-3000 Leuven, Belgium for advice with statistical analysis.

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  1. Virtual Colonoscopy Teaching Centre, Akkerstraat 32 c, 8830, Hooglede, Belgium

    Stefaan Gryspeerdt & Philippe Lefere

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  1. Stefaan Gryspeerdt
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  2. Philippe Lefere
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Correspondence to Stefaan Gryspeerdt.

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Gryspeerdt, S., Lefere, P. Chronic diverticulitis vs. colorectal cancer: findings on CT colonography. Abdom Imaging 37, 1101–1109 (2012). https://doi.org/10.1007/s00261-012-9858-6

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