Öistämö Emma, Hjern Fredrik, Blomqvist Lennart, Von Heijne Anders, Abraham-Nordling Mirna
Department of Clinical Sciences, Division of Surgery, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Acta Radiol. 2013 Apr 1;54(3):237-41. doi: 10.1258/ar.2012.120543. Epub 2013 Jan 14.
Both colon cancer and diverticular disease are common in the Western world. A challenge when patients present with clinical findings is that both diseases can present with symptoms that may mimic the other.
To determine whether magnetic resonance imaging (MRI) could be helpful to differentiate between diverticulitis and cancer of the sigmoid colon compared to the differentiation offered by evaluation of multidetector computed tomography (CT) in a clinical situation.
Thirty patients were consecutively included. Fifteen patients were under work-up for a recently diagnosed sigmoid cancer and 15 patients had recently been treated in hospital due to first-time acute sigmoid diverticulitis. All patients underwent CT, T2- weighted MRI and diffusion-weighted MRI. Anonymized examinations were retrospectively presented in random order to one experienced radiologist.
With contrast-enhanced CT, the sensitivity and specificity for diagnosis of cancer and diverticulitis were 66.7% (10/15) and 93.3% (14/15), respectively. Using T2-weighted and diffusion-weighted MR images, the sensitivity and specificity for diagnosis of cancer and diverticulitis were 100% (14/14) and 100% (14/14), respectively.
MRI provides information that may contribute to improve the differentiation between sigmoid cancer and diverticulitis that is offered by CT. These encouraging results need to be confirmed in a larger study.
结肠癌和憩室病在西方世界都很常见。当患者出现临床症状时，一个挑战是这两种疾病都可能出现相互类似的症状。
与在临床情况下通过多排计算机断层扫描（CT）评估进行鉴别相比，确定磁共振成像（MRI）是否有助于鉴别乙状结肠憩室炎和癌症。
连续纳入30例患者。15例患者正在接受近期诊断出的乙状结肠癌检查，15例患者因首次急性乙状结肠憩室炎近期住院治疗。所有患者均接受了CT、T2加权MRI和扩散加权MRI检查。将匿名检查以随机顺序回顾性呈现给一位经验丰富的放射科医生。
增强CT诊断癌症和憩室炎的敏感性和特异性分别为66.7%（10/15）和93.3%（14/15）。使用T2加权和扩散加权MR图像，诊断癌症和憩室炎的敏感性和特异性分别为100%（14/14）和100%（14/14）。
MRI提供的信息可能有助于改善CT对乙状结肠癌和憩室炎的鉴别。这些令人鼓舞的结果需要在更大规模的研究中得到证实。
