Ultrasonography for suspected mild-to-moderate acute left colonic diverticulitis: a prospective head-to-head study...

Area of Science:

• Gastroenterology
• Radiology
• Medical Imaging

Background:

• The optimal imaging modality for acute left colonic diverticulitis (ALCD) is debated.
• This study prospectively compares ultrasonography (US) and computed tomography (CT) for diagnosing localized mild-to-moderate ALCD.

Purpose of the Study:

• To compare the diagnostic performance of US and CT in patients with suspected mild-to-moderate localized ALCD.
• To assess the agreement between US and CT in stratifying disease severity.

Main Methods:

• Prospective study involving consecutive patients with suspected ALCD undergoing both US and CT within one hour.
• Diagnosis confirmed by a multidisciplinary consensus panel; sensitivity, specificity, PPV, and NPV calculated.
• Agreement for severity stratification assessed using Cohen's kappa coefficient.

Main Results:

• US sensitivity: 97.9%, specificity: 91.7%; CT sensitivity: 98.0%, specificity: 92.3% for ALCD diagnosis.
• Moderate agreement between US and CT for severity staging (κ=0.568), improving with experienced US operators (κ=0.70).
• Higher C-reactive protein levels correlated with increased radiological severity.

Conclusions:

• In selected cases, US by experienced radiologists offers diagnostic performance comparable to CT for ALCD.
• Findings suggest US as a viable alternative in specialized centers with ultrasound expertise.
• Further interpretation requires caution due to sample size and study design limitations.