Acute cholecystitis: quantitative and qualitative evaluation with 64-section helical CT.

Area of Science:

• Radiology
• Medical Imaging
• Gastroenterology

Background:

• Computed Tomography (CT) plays an increasing role in evaluating acute abdominal pain.
• Acute cholecystitis is frequently visualized on CT scans.
• The diagnostic accuracy of specific CT variables for acute cholecystitis remains unclear.

Purpose of the Study:

• To quantitatively and qualitatively analyze findings of acute cholecystitis using 64-section helical CT.
• To assess diagnostic performance with submillimeter and isotropic voxels.
• To compare CT findings between patients with acute cholecystitis and control subjects.

Main Methods:

• Retrospective case-control study involving 40 patients with acute cholecystitis and 40 controls.
• 64-section helical CT examinations were analyzed using submillimeter and isotropic voxels.
• Receiver-operating characteristic (ROC) curve analysis and univariate analysis were employed.

Main Results:

• Key CT findings include pericholecystic fat stranding, mural stratification, and gallbladder wall thickening (≥ 3.6 mm).
• Gallbladder wall thickening and enlarged gallbladder axis (short ≥ 32 mm, long ≥ 74 mm) demonstrated high sensitivity (92.5%) for acute cholecystitis.
• These findings were statistically significant (P < 0.0001) and independent predictors.

Conclusions:

• 64-section helical CT reveals numerous suggestive findings for acute cholecystitis.
• Increased familiarity with these CT indicators can enhance diagnostic confidence.