Guo Jingyi, Yan Fuqiang, Huang Shanshan, Lyu Guorong
Jinjiang Municipal Hospital (Shanghai Sixth People's Hospital Fujian), Quanzhou, China.
Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Abdom Radiol (NY). 2025 Sep 10. doi: 10.1007/s00261-025-05185-3.
This study aims to evaluate the diagnostic accuracy of ultrasonography for acute colonic diverticulitis (ACD) and its ability to differentiate between uncomplicated and complicated diverticulitis.
A comprehensive literature search was conducted from database inception to November 2024. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to appraise study quality. Statistical analyses, including pooled sensitivity, specificity, likelihood ratios, diagnostic odds ratio (using random-effects models), and summary receiver operating characteristic (ROC) curve, were performed using Stata 15.0.
Sixteen studies involving 5,019 subjects were included. The pooled sensitivity and specificity of ultrasonography for diagnosing ACD were 0.92 and 0.97, respectively. The area under the ROC curve was 0.93. For distinguishing uncomplicated from complicated diverticulitis, the sensitivity was 0.93, but specificity was lower at 0.60.
Ultrasonography demonstrated high diagnostic accuracy for ACD (AUC = 0.93), with pooled sensitivity of 0.92 and specificity of 0.97. While it was effective for initial diagnosis, its lower specificity (0.60) in distinguishing uncomplicated from complicated cases suggested it should be integrated with complementary diagnostic modalities to optimize accuracy and guide personalized management strategies.
本研究旨在评估超声检查对急性结肠憩室炎（ACD）的诊断准确性及其区分单纯性和复杂性憩室炎的能力。
从数据库建立至2024年11月进行了全面的文献检索。使用诊断准确性研究质量评估-2（QUADAS-2）工具评估研究质量。使用Stata 15.0进行统计分析，包括合并敏感度、特异度、似然比、诊断比值比（使用随机效应模型）和汇总接受者操作特征（ROC）曲线。
纳入了16项研究，涉及5019名受试者。超声诊断ACD的合并敏感度和特异度分别为0.92和0.97。ROC曲线下面积为0.93。对于区分单纯性和复杂性憩室炎，敏感度为0.93，但特异度较低，为0.60。
超声检查对ACD显示出较高的诊断准确性（AUC = 0.93），合并敏感度为0.92，特异度为0.97。虽然它对初始诊断有效，但其在区分单纯性和复杂性病例时较低的特异度（0.60）表明，应将其与辅助诊断方法相结合，以优化准确性并指导个性化管理策略。
