CT colonography versus colonoscopy in the follow-up of patients after diverticulitis — A prospective, comparative study

Hjern, F.; Jonas, E.; Holmström, B.; Josephson, T.; Mellgren, A.; Johansson, C.

doi:10.1016/j.crad.2007.01.019

« Previous Next »Clinical Radiology
Volume 62, Issue 7 , Pages 645-650, July 2007

CT colonography versus colonoscopy in the follow-up of patients after diverticulitis — A prospective, comparative study

F. Hjern
- Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institut, Stockholm, Sweden
- Guarantor and correspondent: F. Hjern, Department of Surgery, Danderyd Hospital, 182 88 Stockholm, Sweden. Tel.: +46 8 655 69 36; fax: +46 8 655 64 06.
E. Jonas
- Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institut, Stockholm, Sweden
B. Holmström
- Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institut, Stockholm, Sweden
T. Josephson
- Division of Radiology, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
A. Mellgren
- Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institut, Stockholm, Sweden
- Division of Colon and Rectal Surgery, University of Minnesota, Minneapolis, Minnesota, USA
C. Johansson
- Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institut, Stockholm, Sweden

Received 1 May 2006; received in revised form 30 November 2006; accepted 31 January 2007.

Aim

To assess whether computed tomography colonography (CTC) is a viable alternative to colonoscopy or double contrast barium enema in the follow-up of patients after diverticulitis.

Material and methods

Fifty patients underwent CTC followed immediately by colonoscopy. Results were blinded to the examiners. Findings of diverticular disease and patient acceptance were evaluated.

Results

Bowel preparation and distension were good in the majority of CTC and colonoscopy examinations. Diverticular disease was found in 96% of patients at CTC and in 90% at colonoscopy. The rate of agreement between CTC and colonoscopy for diverticular findings in the sigmoid colon was good (κ=0.64). No complications were seen. Patients found colonoscopy more uncomfortable (p<0.03), more painful (p<0.001), and more difficult (p<0.01) than CTC. Of the patients favouring one examination, 74% preferred CTC.

Conclusion

CTC appears to have a better diagnostic potential for imaging of diverticular disease-specific findings, when compared with colonoscopy. Also, CTC was less uncomfortable and was preferred by a majority of patients. CTC seems to be a reasonable alternative in follow-up of patients with symptomatic diverticular disease.