Gray scale cholecystosonography. Diagnostic criteria and accuracy

Area of Science:

• Medical Imaging
• Gastroenterology
• Diagnostic Ultrasound

Background:

• Gallbladder disease, including cholecystitis and cholelithiasis, is a common condition requiring accurate diagnosis.
• Pre-operative imaging is crucial for surgical planning and patient management.

Purpose of the Study:

• To evaluate the diagnostic accuracy of cholecystosonography (ultrasound) in identifying gallbladder disease and gallstones.
• To correlate ultrasonographic findings with pathological examination results.

Main Methods:

• Cholecystosonography was performed on 81 patients with known gallbladder disease prior to cholecystectomy.
• Ultrasonographic patterns of gallstones were categorized: internal echoes, focal contour irregularities, and sonic shadowing.
• Ultrasound findings were compared with surgical and pathological outcomes.

Main Results:

• Pathological examination confirmed gallbladder disease (cholecystitis and/or cholelithiasis) in all but one patient.
• Three distinct ultrasonographic patterns of gallstones were identified.
• Diagnostic confidence improved when internal echoes or contour irregularities were associated with sonic shadowing.
• Failure to visualize the gallbladder on ultrasound correlated with small, shrunken, or stone-filled gallbladders at surgery.
• Gallbladder diameter alone was not a reliable indicator of disease.

Conclusions:

• Cholecystosonography is a valuable tool for diagnosing gallstones and gallbladder disease.
• Specific ultrasonographic patterns enhance diagnostic accuracy.
• Ultrasound can predict intraoperative findings such as a non-visualized or stone-filled gallbladder.