[Computed tomography study of the sigmoid colon: discriminating diagnostic criteria and interobserver correlations].
OBJECTIVE
To assess the value of pericolonic findings at CT in the evaluation of the sigmoid colon.


METHODS
A total of 210 CT examinations were retrospectively reviewed by 3 blinded radiologists. Data was analyzed to determine the interobserver correlation and the value of pericolonic and colonic wall findings in diagnosis of sigmoid colon pathology.


RESULTS
The interobserver correlation for pericolonic findings was equal to or superior to that for colonic wall findings. The presence of abnormal pericolonic fat was the most sensitive (88%) and specific (93%) sign to differentiate a diseased sigmoid colon from a normal one or from sigmoid diverticulosis. Wall-thickening was less sensitive (82%) and specific (76%). Findings suggesting malignancy over diverticulitis included acute zone of transition, focal fatty infiltration, and lymph nodes. Symmetrical and circumferential wall thickening, target-like enhancement, and local fatty proliferation were findings suggesting colitis over diverticulitis. Wall thickening more than 15 mm, involvement of 15 cm or less, asymmetrical involvement, acute zone of transition, and homogeneous or heterogeneous enhancement were findings suggesting malignancy over colitis.


CONCLUSIONS
To render a diagnosis, the evaluation of the fat infiltration must prevail on the parietal thickening appreciation.
Lefèvre
F
F
Service de Radiologie, Hôpital d'Adultes, CHU Nancy-Brabois, Vandoeuvre. lefevref@planete.net
Béot
S
S
Chapuis
F
F
Deneuville
M
M
Gaucher
H
H
Debelle
L
L
Boccaccini
H
H
Bazin
C
C
Régent
D
D
D000273:Adipose Tissue / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003092:Colitis / Q000000981:diagnostic imaging; D012809:Colon, Sigmoid / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D004239:Diverticulitis, Colonic / Q000000981:diagnostic imaging; D004241:Diverticulum, Colon / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012810:Sigmoid Diseases / Q000000981:diagnostic imaging*; D012811:Sigmoid Neoplasms / Q000000981:diagnostic imaging; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed
Exploration tomodensitométrique du côlon sigmoïde: critères diagnostiques discriminants et corrélations interobservateurs.