Low sensitivity of sonography and cholescintigraphy in acalculous cholecystitis

Acalculous cholecystitis is difficult to diagnose by clinical means or contrast radiography. Because sonography and cholescintigraphy have both been shown to do well in the diagnosis of calculous cholecystitis, the sensitivity of these newer imaging methods was assessed retrospectively in 33 proven cases of acalculous cholecystitis. The sensitivities to acalculous cholecystitis for sonography (67%) and for cholescintigraphy (68%) were not as high as has been reported for these tests in calculous cholecystitis. Reasons for the lower sensitivity with each test and the pathogenesis of acalculous cholecystitis are discussed.