Pillari G, Greenspan B, Vernace F M, Rosenblum G
Gastrointest Radiol. 1984;9(3):263-8. doi: 10.1007/BF01887847.
Six cases of diverticulitis were studied by means of pelvic computed tomography (CT) and contrast enema. CT is effective in defining the intramural and extracolonic component of diverticulitis; abscess formation in the extracolonic space resulted in consistent changes in the contour of the opacified urinary bladder. Inflammatory extracolonic masses were imaged on CT as low or mixed-attenuation lesions frequently containing pockets of gas. Bladder wall thickening and edema, as well as contour asymmetry of the opacified and distended bladder, were reliable indicators of pericolonic or extracolonic extension of diverticular disease. Contrast enema and sigmoidoscopy are inherently limited in the evaluation of diverticulitis; CT of the pelvis reveals secondary changes outside the mucosa and bowel wall, CT directly images the inflammatory mass and associated changes in pelvic anatomic relationships. CT findings of pelvic inflammatory mass are not specific for abscess of diverticular origin; however, CT interpretation is reliable and confident since it is directed by the supporting findings on contrast enema. Integrated study by CT and contrast enema effectively defines the extent of disease in patients with diverticulitis. Summary evaluation of these studies has a serious impact on the choice of medical or surgical management.
通过盆腔计算机断层扫描（CT）和钡剂灌肠对6例憩室炎患者进行了研究。CT在确定憩室炎的壁内和结肠外成分方面很有效；结肠外间隙的脓肿形成导致造影剂充盈的膀胱轮廓出现一致性改变。炎性结肠外肿块在CT上表现为低密度或混合密度病变，常含有气体腔隙。膀胱壁增厚、水肿以及造影剂充盈且扩张的膀胱轮廓不对称，是憩室病结肠周围或结肠外扩展的可靠指标。钡剂灌肠和乙状结肠镜检查在评估憩室炎方面存在固有局限性；盆腔CT可显示黏膜和肠壁外的继发性改变，CT能直接成像炎性肿块以及盆腔解剖关系的相关改变。盆腔炎性肿块的CT表现并非憩室源性脓肿所特有；然而，由于CT解释是由钡剂灌肠的支持性表现所指导，所以其解释可靠且确定。CT和钡剂灌肠的综合研究能有效确定憩室炎患者的疾病范围。这些研究的总结性评估对药物或手术治疗方案的选择有严重影响。
