Moll R, Mittelkötter U, Reith H B, Schindler G, Thiede A
Abteilung für Röntgendiagnostik, Chirurgische Klinik und Poliklinik der Universität Würzburg, Germany.
Zentralbl Chir. 2002 Apr;127(4):297-301. doi: 10.1055/s-2002-31552.
Sigmoid diverticulitis is in case of complications like perforation, abscess and peritonitis a life-threatening disease. A diagnostic work up with high sensitivity is mandatory. In a prospective study upon 247 patients with the possible diagnosis of acute diverticulitis ultrasound is a screening method with a high specificity (97 %) and leads in combination with the hydrocolonsonography and the colour flow doppler to a high sensitivity (76 %). Without any typical findings in ultrasound, helical CT scan is the best method in the evaluation of the acute diverticulitis (sensitivity and specificity 100 %), because contrast enema is inferior to CT in the evaluation of abscesses (6 %) and perforation (53 %). CT has in case of perforation and of abscesses a sensitivity of 90 % and 100 %, while ultrasound has a sensitivity of 12 % to perforation and of 39 % to abscesses.
乙状结肠憩室炎在出现穿孔、脓肿和腹膜炎等并发症时是一种危及生命的疾病。必须进行具有高敏感性的诊断检查。在一项针对247例可能诊断为急性憩室炎患者的前瞻性研究中,超声是一种具有高特异性(97%)的筛查方法,与水灌肠造影和彩色多普勒血流成像相结合可达到高敏感性(76%)。如果超声没有任何典型表现,螺旋CT扫描是评估急性憩室炎的最佳方法(敏感性和特异性均为100%),因为在评估脓肿(6%)和穿孔(53%)方面,结肠造影不如CT。对于穿孔和脓肿,CT的敏感性分别为90%和100%,而超声对穿孔的敏感性为12%,对脓肿的敏感性为39%。