Chronic cholecystitis ultrasound: Difference between revisions
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Revision as of 19:18, 2 June 2015
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Chronic cholecystitis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Chronic cholecystitis ultrasound On the Web |
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American Roentgen Ray Society Images of Chronic cholecystitis ultrasound |
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Risk calculators and risk factors for Chronic cholecystitis ultrasound |
Overview
Sonography is a sensitive and specific modality for diagnosis of acute cholecystitis; adjusted sensitivity and specificity for diagnosis of acute cholecystitis are 88% and 80%, respectively. The 2 major diagnostic criteria are cholelithiasis and sonographic Murphy's sign. Minor criteria includes gallbladder wall thickening greater than 3mm, pericholecystic fluid, and gallbladder dilatation. [1] [2]
Ultrasound
- This is the first test to be done in any suspected cases of cholecystitis.
- Sonography is the fastest, most cost effective, and most accurate diagnostic modality.
- Sensitivity is reported to be as high as 90-95%.
Calculous Cholecystitis
- Acute calculous cholecystitis is diagnosed radiologically by the presence of
- Thickening of gallbladder (5mm or greater)
- Pericholecystic fluid
- Probe tenderness (ultrasonographic Murphy's sign)
Acalculous Cholecystitis
The ultrsound based diagnostic criteria from multiple studies for acalculous cholecystits is as follows.[3]
| Criteria | Diagnosis |
|---|---|
| Major | 3.5 to 4 mm (or more) thick wall (if at least 5 cm distended longitudinally with no ascites or hypoalbuminemia) Pericholecystic fluid (halo)/subserosal edema Intramural gas Sloughed mucosal membrane |
| Minor | Echogenic bile (sludge) Hydrops = distension greater than 8-cm longitudinally or 5-cm transversely (with clear fluid) |
Diagnosis: 2 major or 1 major and 2 minor (most studies have favored the diagnostic triad: wall thickness, sludge, hydrops).
Chronic Calculous and Acalculous Cholecystitis
Ultrasound features of chronic cholecystitis can be non specific. Cholelithiasis with contracted or distended but thickened gallbladder and without any pericholecystic inflammation can be the findings.[4]
References
- ↑ Shea, JA, Berlin, JA, Escarce, JJ, et al. Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease. Arch Intern Med 1994; 154:2573.
- ↑ Fink-Bennett, D, Freitas, JE, Ripley, SD, Bree, RL. The sensitivity of hepatobiliary imaging and real time ultrasonography in the detection of acute cholecystitis. Arch Surg 1985; 120:904.
- ↑ Huffman, JL.; Schenker, S. (2010). "Acute acalculous cholecystitis: a review". Clin Gastroenterol Hepatol. 8 (1): 15–22. doi:10.1016/j.cgh.2009.08.034. PMID 19747982. Unknown parameter
|month=ignored (help) - ↑ Yun, EJ.; Cho, SG.; Park, S.; Park, SW.; Kim, WH.; Kim, HJ.; Suh, CH. "Gallbladder carcinoma and chronic cholecystitis: differentiation with two-phase spiral CT". Abdom Imaging. 29 (1): 102–8. doi:10.1007/s00261-003-0080-4. PMID 15160762.