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Ultrasound criteria for differential diagnosis between colonic diverticulosis and sigmoid colon cancer

https://doi.org/10.24835/1607-0771-2018-2-37-47

Abstract

28 patients with unclear diagnosis (complicated colonic diverticulosis or sigmoid colon cancer) were included in this study. Ultrasound examination was performed in all patients, colonoscopy - in 23 (82.1%), contrast enema - in 10 (35.7%), computed tomography - in 14 (50.0%). 25 (89.3%) patients underwent surgery. The 1st group included 13 (46.4%) patients with complicated colonic diverticulosis, the 2nd group - 15 (53.6%) patients with a sigmoid colon cancer (8 of them in combination with diverticular disease). There were no significant differences of clinical findings between groups of patients. The most sensitive ultrasound signs for sigmoid colon cancer diagnosis were: colonic wall structure disorganization, irregular colonic wall thickening, pathological area length <10 cm, and disappearance of haustra. The most sensitive ultrasound signs for inflammatory complications of diverticular disease were: regular colonic wall thickening, wall thickness <15 mm, pathological area length ≥10 cm, pathological area indistinct boundaries, hyperhaustration, and colonic wall normal structure. In order to increase the efficacy of ultrasound in the diagnosis of sigmoid colon cancer, a scoring system has been proposed. In cases, when ultrasound sign for sigmoid colon cancer was obtained, 1 or 2 points were added according to its sensitivity (2 points for signs with sensitivity ≥80%, 1 point for signs with less sensitivity). The diagnostic test “5points or more - sigmoid colon cancer’ had sensitivity of 86.7%, specificity of 100.0%, and area under the curve of 0.959. Ultrasound can be used for differential diagnosis between complicated colonic diverticulosis and sigmoid colon cancer, especially in cases of CT unclear findings or CT contraindications presence.

For citations:


Trubacheva Yu.L., Orlova L.P., Moskalev A.I., Evgrafov P.G. Ultrasound criteria for differential diagnosis between colonic diverticulosis and sigmoid colon cancer. Ultrasound & Functional Diagnostics. 2018;(2):37-47. (In Russ.) https://doi.org/10.24835/1607-0771-2018-2-37-47

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ISSN 1607-0771 (Print)
ISSN 2408-9494 (Online)