Purpose: To diagonose diverticulitis more precisely and differentiate from appendicitis, diverticulitis of right side colon was tried to visualize on US and its sonographic findings were studied.
Methods: Ultrasonic examinations were performed in 20 patients with diverticulitis but no appendicitis. To obtain higher resolution, digital machines were used such as HDI-3000 (ATL) and EUB-8500 (HITACHI), equipped with high frequency transducers.
Results: Thickend colonic wall was observed in all cases and terminal ileum wall swelling was also visualized in 16 of 20 cases(80%). Whereas lymph node swelling was in only 2 cases.Visualization of normal appendix was possible in 15 cases, which is important to deny appendicitis. Diverticula themselves could be recognized in 15 of 20 (75%) patients as 3 image patterns shown on US , which were, 1) round hypoechoic foci for 2 cases, 2) hypoechoic masses with central echogenic foci ( target pattern ) in 4 cases, and 3) round layers structures in 9 cases. Of these 9 cases, defects of muscular layer could be first recognized in 5 cases which were very specific findings to diverticula. All patients were recoverd by antibiotic therapy with no surgical treatments and clinical course of US images in these patients were also demondtrated.
Conclusion: Recent advances in digital machines enables us to visualize diverticula directly with high rate and findings of layers pattern were newly recognized. Especially, Lack of Muscular layer in the lesions vizualized on US, was definitely specific to diagnosis of diverticulitis.