Johnson C D, Baker M E, Rice R P, Silverman P, Thompson W M
AJR Am J Roentgenol. 1987 Mar;148(3):541-6. doi: 10.2214/ajr.148.3.541.
The contrast enema and CT studies in 102 patients with a clinical diagnosis (41%) or surgically confirmed (59%) diagnosis of colonic diverticulitis were reviewed retrospectively to determine the sensitivity of the two techniques. Combined results from all patients showed that the contrast enema was correct in 77% of patients. The contrast enema was falsely negative in 15% and was indeterminate in 7%. The CT examination was diagnostic in 41%, consistent with the diagnosis of diverticulitis in 38%, and falsely negative in 21% of patients. Both CT and contrast enemas were more accurate in patients with severe disease requiring surgery. No complications occurred from 109 enemas performed. Patient management was altered in only one patient as a result of the additional information provided by CT. The contrast enema should remain the initial and routine examination for the evaluation of patients with suspected diverticulitis. CT should be reserved for patients who are unable to have an adequate contrast enema, those with suspected distant or diffuse abdominal abscess, those who are unresponsive to medical therapy, and those who are candidates for percutaneous drainage.
对102例临床诊断（41%）或手术确诊（59%）为结肠憩室炎的患者的对比灌肠和CT检查进行回顾性分析，以确定这两种技术的敏感性。所有患者的综合结果显示，对比灌肠在77%的患者中诊断正确。对比灌肠假阴性率为15%，不确定率为7%。CT检查诊断率为41%，38%的患者诊断结果与憩室炎一致，21%的患者为假阴性。CT和对比灌肠对需要手术的重症患者诊断更准确。109次灌肠均未出现并发症。仅1例患者因CT提供的额外信息而改变了治疗方案。对比灌肠仍应作为疑似憩室炎患者的初始和常规检查。CT应保留给那些无法进行充分对比灌肠的患者、疑似远处或弥漫性腹腔脓肿的患者、对药物治疗无反应的患者以及适合经皮引流的患者。
