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Imaging acute cholecystitis, one test is enough.

Kevin M Schuster1, Thomas J Schroeppel2, Rick O'Connor1

  • 1Department of Surgery, Yale School of Medicine, New Haven, CT, USA.

American Journal of Surgery
|March 7, 2023
PubMed
Summary

Multiple imaging studies for acute cholecystitis provide similar results for key diagnostic parameters. This suggests a single imaging modality may be sufficient for diagnosis, improving patient care.

Keywords:
CT scanCholecystitisImaging measurementsMagnetic resonance imagingUltrasound

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Area of Science:

  • Radiology
  • Gastroenterology
  • Medical Imaging

Background:

  • Right upper quadrant pain diagnosis often involves multiple imaging studies.
  • No definitive gold standard exists for imaging in these cases.
  • A single imaging study should ideally provide sufficient diagnostic information.

Purpose of the Study:

  • To compare the diagnostic accuracy of multiple imaging modalities for acute cholecystitis.
  • To determine if a single imaging study is adequate for diagnosis.

Main Methods:

  • A multicenter study analyzed patients with acute cholecystitis who underwent multiple imaging studies.
  • Compared parameters included wall thickness (WT) and common bile duct diameter (CBDD).
  • Statistical analysis used chi-square tests and Intra-class correlation coefficients (ICC).

Main Results:

  • Excellent agreement was found for WT (ICC=0.733) and CBDD (ICC=0.848) across ultrasound, CT, and MRI.
  • Differences in measured parameters between studies were minimal (<1 mm).
  • Significant discrepancies (>2 mm) were rare (<5%).

Conclusions:

  • Imaging studies for acute cholecystitis yield comparable results for standard parameters.
  • This equivalence supports the use of a single imaging modality for diagnosis.