{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:44:39Z","timestamp":1787762679357,"version":"build-2784847793"},"reference-count":43,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T00:00:00Z","timestamp":1701993600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Acute colonic diverticulitis (ACD) is the most common complication of diverticular disease and represents an abdominal emergency. It includes a variety of conditions, extending from localized diverticular inflammation to fecal peritonitis, hence the importance of an accurate diagnosis. Contrast-enhanced computed tomography (CE-CT) plays a pivotal role in the diagnosis due to its high sensitivity, specificity, accuracy, and interobserver agreement. In fact, CE-CT allows alternative diagnoses to be excluded, the inflamed diverticulum to be localized, and complications to be identified. Imaging findings have been reviewed, dividing them into bowel and extra-intestinal wall findings. Moreover, CE-CT allows staging of the disease; the most used classifications of ACD severity are Hinchey\u2019s modified and WSES classifications. Differential diagnoses include colon carcinoma, epiploic appendagitis, ischemic colitis, appendicitis, infectious enterocolitis, and inflammatory bowel disease. We propose a structured reporting template to standardize the terminology and improve communication between specialists involved in patient care.<\/jats:p>","DOI":"10.3390\/diagnostics13243628","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T08:47:26Z","timestamp":1702025246000},"page":"3628","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Acute Colonic Diverticulitis: CT Findings, Classifications, and a Proposal of a Structured Reporting Template"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9637-1970","authenticated-orcid":false,"given":"Francesco","family":"Tiralongo","sequence":"first","affiliation":[{"name":"Radiology Unit 1, University Hospital Policlinico \u201cG. Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6785-0737","authenticated-orcid":false,"given":"Stefano","family":"Di Pietro","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University Hospital Policlinico \u201cG. Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Milazzo","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University Hospital Policlinico \u201cG. Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastiano","family":"Galioto","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University Hospital Policlinico \u201cG. Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide Giuseppe","family":"Castiglione","sequence":"additional","affiliation":[{"name":"Radiology Unit 1, University Hospital Policlinico \u201cG. Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7529-2680","authenticated-orcid":false,"given":"Corrado","family":"Ini\u2019","sequence":"additional","affiliation":[{"name":"Radiology Unit 1, University Hospital Policlinico \u201cG. Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro Valerio","family":"Foti","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University Hospital Policlinico \u201cG. Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Mosconi","sequence":"additional","affiliation":[{"name":"Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant\u2019Orsola-Malpighi Hospital, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Giurazza","sequence":"additional","affiliation":[{"name":"Interventional Radiology Department, Cardarelli Hospital of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Venturini","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Circolo Hospital, Insubria University, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3665-8325","authenticated-orcid":false,"given":"Guido Nicola","family":"Zanghi\u2019","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7196-2974","authenticated-orcid":false,"given":"Stefano","family":"Palmucci","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University Hospital Policlinico \u201cG. Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Basile","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University Hospital Policlinico \u201cG. Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,8]]},"reference":[{"key":"ref_1","first-page":"8","article-title":"Diverticulosis, diverticular disease and diverticulitis\u2014Definitions and differences","volume":"35","author":"Hong","year":"2015","journal-title":"J. Stomal Ther. Aust."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1590\/0100-3984.2015.0227","article-title":"What radiologists should know about tomographic evaluation of acute diverticulitis of the colon","volume":"50","author":"Naves","year":"2017","journal-title":"Radiol. Bras."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"109026","DOI":"10.1016\/j.ejrad.2020.109026","article-title":"Acute diverticulitis: Key features for guiding clinical management","volume":"128","author":"Sugi","year":"2020","journal-title":"Eur. J. Radiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/S0140-6736(04)15597-9","article-title":"Diverticular disease of the colon","volume":"363","author":"Stollman","year":"2004","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s13244-016-0532-3","article-title":"Diverticulitis: A comprehensive review with usual and unusual complications","volume":"8","author":"Onur","year":"2017","journal-title":"Insights Imaging"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1053\/j.gastro.2018.12.033","article-title":"Epidemiology, Pathophysiology, and Treatment of Diverticulitis","volume":"156","author":"Strate","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S141","DOI":"10.1016\/j.jacr.2019.02.015","article-title":"ACR Appropriateness Criteria\u00ae Left Lower Quadrant Pain-Suspected Diverticulitis","volume":"16","author":"Galgano","year":"2019","journal-title":"J. Am. Coll. Radiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s13017-020-00313-4","article-title":"2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting","volume":"15","author":"Sartelli","year":"2020","journal-title":"World J. Emerg. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/1749-7922-8-3","article-title":"2013 WSES guidelines for management of intra-abdominal infections","volume":"8","author":"Sartelli","year":"2013","journal-title":"World J. Emerg. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/1749-7922-10-3","article-title":"A proposal for a CT driven classification of left colon acute diverticulitis","volume":"10","author":"Sartelli","year":"2015","journal-title":"World J. Emerg. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.2214\/ajr.178.6.1781313","article-title":"Frequency, Sensitivity, and Specificity of Individual Signs of Diverticulitis on Thin-Section Helical CT with Colonic Contrast Material: Experience with 312 Cases","volume":"178","author":"Kircher","year":"2002","journal-title":"Am. J. Roentgenol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1055\/s-0029-1236158","article-title":"Imaging Update: Acute Colonic Diverticulitis","volume":"22","author":"DeStigter","year":"2009","journal-title":"Clin. Colon Rectal Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"546","DOI":"10.5152\/dir.2020.19645","article-title":"CT of the acute colonic diverticulitis: A pictorial essay","volume":"26","author":"Minordi","year":"2020","journal-title":"Diagn. Interv. Radiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"421","DOI":"10.5694\/mja2.50276","article-title":"The management of diverticulitis: A review of the guidelines","volume":"211","author":"You","year":"2019","journal-title":"Med. J. Aust."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1007\/s00268-009-0379-6","article-title":"CT Scan for Suspected Acute Abdominal Process: Impact of Combinations of IV, Oral, and Rectal Contrast","volume":"34","author":"Hill","year":"2010","journal-title":"World J. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1148\/radiographics.20.2.g00mc15399","article-title":"CT Evaluation of the Colon: Inflammatory Disease","volume":"20","author":"Horton","year":"2000","journal-title":"RadioGraphics"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.jemermed.2012.08.027","article-title":"Emergency Department Contrast Practices for Abdominal\/Pelvic Computed Tomography\u2014A National Survey and Comparison with the American College of Radiology Appropriateness Criteria\u00ae","volume":"44","author":"Broder","year":"2013","journal-title":"J. Emerg. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/s13244-013-0308-y","article-title":"Bowel wall thickening at CT: Simplifying the diagnosis","volume":"5","author":"Fernandes","year":"2014","journal-title":"Insights Imaging"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/00004728-200201000-00015","article-title":"Normal Colonic Wall Thickness at CT and Its Relation to Colonic Distension","volume":"26","author":"Wiesner","year":"2002","journal-title":"J. Comput. Assist. Tomogr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1148\/radiol.2017161374","article-title":"Recurrence of Colonic Diverticulitis: Identifying Predictive CT Findings\u2014Retrospective Cohort Study","volume":"285","author":"Dickerson","year":"2017","journal-title":"Radiology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1148\/rg.243035084","article-title":"Disproportionate Fat Stranding: A Helpful CT Sign in Patients with Acute Abdominal Pain","volume":"24","author":"Pereira","year":"2004","journal-title":"RadioGraphics"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s13244-010-0051-6","article-title":"CT findings of misleading features of colonic diverticulitis","volume":"2","author":"Zins","year":"2011","journal-title":"Insights Imaging"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1097\/00007611-199305000-00020","article-title":"Pylephiebitis Associated With Diverticulitis","volume":"86","author":"Grable","year":"1993","journal-title":"South. Med. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1055\/s-0034-1399526","article-title":"S2k Guidlines for Diverticular Disease and Diverticulitis: Diagnosis, Classification, and Therapy for the Radiologist","volume":"187","author":"Schreyer","year":"2015","journal-title":"Fortschr. R\u00f6ntgenstr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1159\/000336620","article-title":"Ultrasound of Colon Diverticulitis","volume":"30","author":"Puylaert","year":"2012","journal-title":"Dig. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1053\/j.sult.2015.10.003","article-title":"Acute Perforated Diverticulitis: Assessment With Multidetector Computed Tomography","volume":"37","author":"Sessa","year":"2016","journal-title":"Semin. Ultrasound CT MRI"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1111\/j.1440-1746.2011.06851.x","article-title":"Cryptogenic pyogenic liver abscess as the herald of colon cancer: Colon cancer in cryptogenic liver abscess","volume":"27","author":"Jeong","year":"2012","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1007\/BF02556792","article-title":"Internal fistulas in diverticular disease","volume":"31","author":"Woods","year":"1988","journal-title":"Dis. Colon Rectum"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1055\/s-0037-1607962","article-title":"Surgical Management of Diverticular Disease in the Elective Setting","volume":"31","author":"Neale","year":"2018","journal-title":"Clin. Colon Rectal Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.2214\/AJR.13.12250","article-title":"Colorectal Emergencies and Related Complications: A Comprehensive Imaging Review\u2014Imaging of Colitis and Complications","volume":"203","author":"Maddu","year":"2014","journal-title":"Am. J. Roentgenol."},{"key":"ref_31","first-page":"85","article-title":"Treatment of perforated diverticular disease of the colon","volume":"12","author":"Hinchey","year":"1978","journal-title":"Adv. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1111\/j.1572-0241.2005.41154.x","article-title":"The Management of Complicated Diverticulitis and the Role of Computed Tomography","volume":"100","author":"Kaiser","year":"2005","journal-title":"Am. J. Gastroenterol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1097\/TA.0b013e3182aafdba","article-title":"Measuring anatomic severity of disease in emergency general surgery","volume":"76","author":"Shafi","year":"2014","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.jss.2020.10.016","article-title":"Prospectively Assigned AAST Grade versus Modified Hinchey Class and Acute Diverticulitis Outcomes","volume":"259","author":"Choi","year":"2021","journal-title":"J. Surg. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1097\/TA.0000000000002650","article-title":"Comparison of American Association for the Surgery of Trauma grading scale with modified Hinchey classification in acute colonic diverticulitis: A pilot study","volume":"88","author":"Ebersole","year":"2020","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Cremonini, C., Biloslavo, A., Robustelli, V., Giannessi, S., Rossi Del Monte, S., Mastronardi, M., Musetti, S., Strambi, S., Coccolini, F., and Chiarugi, M.M. (2023). What are the differences between the three most used classifications for acute colonic diverticulitis? A comparative multicenter study: Acute diverticulitis classifications comparison. J. Trauma Acute Care Surg., 10\u201397.","DOI":"10.1097\/TA.0000000000004133"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1148\/radiol.14132829","article-title":"Sigmoid Cancer versus Chronic Diverticular Disease: Differentiating Features at CT Colonography","volume":"275","author":"Lips","year":"2015","journal-title":"Radiology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.2214\/ajr.183.5.1831303","article-title":"CT Appearance of Acute Appendagitis","volume":"183","author":"Singh","year":"2004","journal-title":"Am. J. Roentgenol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1148\/rg.256055030","article-title":"Acute Epiploic Appendagitis and Its Mimics","volume":"25","author":"Singh","year":"2005","journal-title":"RadioGraphics"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1148\/radiol.11101913","article-title":"Improving Communication of Diagnostic Radiology Findings through Structured Reporting","volume":"260","author":"Schwartz","year":"2011","journal-title":"Radiology"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1148\/rg.322115128","article-title":"Quality Initiatives: Lean Approach to Improving Performance and Efficiency in a Radiology Department","volume":"32","author":"Kruskal","year":"2012","journal-title":"RadioGraphics"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1007\/s00261-020-02468-9","article-title":"Reporting of acute pancreatitis by radiologists-time for a systematic change with structured reporting template","volume":"45","author":"Khurana","year":"2020","journal-title":"Abdom. Radiol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Granata, V., Caruso, D., Grassi, R., Cappabianca, S., Reginelli, A., Rizzati, R., Masselli, G., Golfieri, R., Rengo, M., and Regge, D. (2021). Structured Reporting of Rectal Cancer Staging and Restaging: A Consensus Proposal. Cancers, 13.","DOI":"10.3390\/cancers13092135"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/24\/3628\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:35:41Z","timestamp":1760132141000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/24\/3628"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,8]]},"references-count":43,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["diagnostics13243628"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13243628","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,8]]}}}