Acute colonic diverticulitis: visualization in magnetic resonance imaging

Heverhagen, Johannes T.; Zielke, A.; Ishaque, Natascha; Bohrer, Thomas; El-Sheik, Michael; Klose, Klaus–Jochen

doi:10.1016/s0730-725x(01)00469-6

Cited by 34 publications

(29 citation statements)

References 8 publications

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“…In the future, there might be a place for MRI in the assessment of patients with acute abdominal pain. Recent studies have demonstrated that MRI is sufficiently accurate to diagnose appendicitis and diverticulitis [30,31]. The advantage of MRI over computed tomography is that no administration of contrast media is necessary and that there is no ionizing radiation exposure.…”

Section: Resultsmentioning

confidence: 99%

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Guideline for the Diagnostic Pathway in Patients with Acute Abdominal Pain

Gans

Pols²,

Stoker³

et al. 2015

Dig Surg

169

117

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Introduction: Diagnostic practice for acute abdominal pain at the Emergency Department varies widely and is mostly based on doctor's preferences. We aimed at developing an evidence-based guideline for the diagnostic pathway of patients with abdominal pain of non-traumatic origin. Methods: All available international literature on patients with acute abdominal pain was identified and graded according to their methodological quality by members of the multidisciplinary steering group. A guideline was synthetized, providing evidence-based recommendations together with considerations based on expertise of group members, patient preferences, costs, availability of facilities, and organizational aspects. Conclusions and Recommendations: Definition: Uniform terminology is needed in patients with acute abdominal pain to avoid difficulty in interpretation and ease comparison of findings between studies. We propose the use of the following definition for acute abdominal pain: pain of nontraumatic origin with a maximum duration of 5 days. Clinical diagnosis: Clinical evaluation is advised to differentiate between urgent and nonurgent causes. The diagnostic accuracy of clinical assessment is insufficient to identify the correct diagnosis but can discriminate between urgent and nonurgent causes. Patients suspected of nonurgent diagnoses can safely be reevaluated the next day. Based on current literature, no conclusions can be drawn on the differences in accuracy between residents and specialists. No conclusions can be drawn on the influence of a gynecological consultation. In patients suspected of an urgent condition, additional imaging is justified. CRP and WBC count alone are insufficient to discriminate urgent from nonurgent diagnoses. Diagnostic imaging: There is no place for conventional radiography in the work-up of patients with acute abdominal pain due to the lack of added value on top of clinical assessment. Computed tomography leads to the highest sensitivity and specificity in patients with acute abdominal pain. Positive predictive value of ultrasound is comparable with CT and therefore preferred as the first imaging modality due to the downsides of computed tomography; negative or inconclusive ultrasound is followed by CT. Based on current literature, no conclusions can be drawn on the added value of a diagnostic laparoscopy in the work-up of patients with acute abdominal pain. Antibiotic treatment should be started within the first hour after recognition of sepsis. Administration of opioids (analgesics) decreases the intensity of the pain and does not affect the accuracy of physical examination.

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Section: Resultsmentioning

confidence: 99%

“…The downside is that MRI scanners are not yet widely available and that the assessment of MRI images needs specific training [32]. For pregnant women with a suspicion of an urgent cause, an MRI should be contemplated, because of the serious consequences of a missed diagnosis [30,31]. …”

Section: Resultsmentioning

confidence: 99%

Guideline for the Diagnostic Pathway in Patients with Acute Abdominal Pain

Gans

Pols²,

Stoker³

et al. 2015

Dig Surg

169

117

View full text Add to dashboard Cite

show abstract

“…20 The authors found similar sensitivity (86 percent) and specificity (92 percent). In preliminary studies, feasibility of the diagnosis of ACD in MRI 15 and sequence optimization 13 have been described. In a recent review, Buckley et al 21 described findings in patients with ACD.21 Our results also compared favorably with those reported for CT. 2,9 Both assessors agreed in approximately 90 percent of all cases.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors already assessed MRI in the depiction of ACD, but the reports were mostly anecdotal and the case numbers were limited. [13][14][15] Therefore, the purpose of our study was to prospectively investigate a larger patient population with suspected ACD and to provide estimates for sensitivity and specificity as well as interobserver agreement in a blinded trial.…”

mentioning

confidence: 99%

Prospective Evaluation of the Value of Magnetic Resonance Imaging in Suspected Acute Sigmoid Diverticulitis

Heverhagen¹,

Sitter²,

Zielke³

et al. 2008

Diseases of the Colon &Amp; Rectum

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“…They were able to perform the image protocol in 11 min. In a later paper, Heverhagen et al [23] also demonstrated that MRI may be used to detect complications of diverticulitis such as abscess formation.…”

Section: Mri and Inflammatory Conditions Of The Bowelmentioning

confidence: 99%

Pictorial review: magnetic resonance imaging of colonic diverticulitis

et al. 2006

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Magnetic resonance imaging (MRI) is rapidly emerging as a useful imaging modality for the evaluation of the gastrointestinal tract. Increasingly rapid sequences and improving hardware have significantly improved the visualisation of diseases of the colon. MRI has a major advantage over CT in that there is no ionising radiation. In our institution, MRI has increasingly been used as a complimentary imaging modality to CT in the diagnosis and evaluation of diverticulitis and its complications. In this review article, we illustrate the emerging role of MRI in the diagnosis and evaluation of colonic diverticulitis.

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Acute colonic diverticulitis: visualization in magnetic resonance imaging

Cited by 34 publications

References 8 publications

Guideline for the Diagnostic Pathway in Patients with Acute Abdominal Pain

Guideline for the Diagnostic Pathway in Patients with Acute Abdominal Pain

Prospective Evaluation of the Value of Magnetic Resonance Imaging in Suspected Acute Sigmoid Diverticulitis

Pictorial review: magnetic resonance imaging of colonic diverticulitis

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