Acute cholecystitis other imaging findings: Difference between revisions

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==Overview==
==Overview==


Cholescintigraphy which utilizes technetium-labeled hepatic 2,6-dimethyl-iminodiacetic acid (HIDA) may be helpful in the diagnosis of acute cholecystitis. Findings on a cholescintigraphy diagnostic of acute cholecystitis include lack of visualization of the gallbladder.
[[Cholescintigraphy]] is the '''gold standard''' for the diagnosis of acute cholecystitis. [[Cholescintigraphy]] is an alternative method of imaging and uses technetium-labeled [[HIDA scan|hepatic 2,6-dimethyl-iminodiacetic acid]] ([[HIDA scan|HIDA]]) in difficult cases or uncertain diagnosis. Findings on a [[cholescintigraphy]] diagnostic of acute cholecystitis include lack of visualization of the [[gallbladder]].


==Other Imaging Findings==
==Other Imaging Findings==
*Cholescintigraphy which utilizes technetium-labeled hepatic 2,6-dimethyl-iminodiacetic acid (HIDA) may be helpful in the diagnosis of acute cholecystitis.  
*[[Cholescintigraphy]] which utilizes technetium-labeled [[HIDA scan|hepatic 2,6-dimethyl-iminodiacetic acid]] ([[HIDA scan|HIDA]]) is the '''gold standard''' for the diagnosis of acute cholecystitis. [[Cholescintigraphy]] is used in difficult cases or uncertain diagnosis.<ref name="pmid24679431">{{cite journal |vauthors=Knab LM, Boller AM, Mahvi DM |title=Cholecystitis |journal=Surg. Clin. North Am. |volume=94 |issue=2 |pages=455–70 |year=2014 |pmid=24679431 |doi=10.1016/j.suc.2014.01.005 |url=}}</ref><ref name="pmid28603584">{{cite journal |vauthors=Gomes CA, Junior CS, Di Saverio S, Sartelli M, Kelly MD, Gomes CC, Gomes FC, Corrêa LD, Alves CB, Guimarães SF |title=Acute calculous cholecystitis: Review of current best practices |journal=World J Gastrointest Surg |volume=9 |issue=5 |pages=118–126 |year=2017 |pmid=28603584 |pmc=5442405 |doi=10.4240/wjgs.v9.i5.118 |url=}}</ref><ref name="pmid22798223">{{cite journal |vauthors=Kiewiet JJ, Leeuwenburgh MM, Bipat S, Bossuyt PM, Stoker J, Boermeester MA |title=A systematic review and meta-analysis of diagnostic performance of imaging in acute cholecystitis |journal=Radiology |volume=264 |issue=3 |pages=708–20 |year=2012 |pmid=22798223 |doi=10.1148/radiol.12111561 |url=}}</ref><ref name="urlImaging of Cholecystitis : American Journal of Roentgenology : Vol. 196, No. 4 (AJR)">{{cite web |url=http://www.ajronline.org/doi/full/10.2214/AJR.10.4340 |title=Imaging of Cholecystitis : American Journal of Roentgenology : Vol. 196, No. 4 (AJR) |format= |work= |accessdate=}}</ref>
*Findings on a cholescintigraphy diagnostic of acute cholecystitis include:
**Findings on a [[cholescintigraphy]] diagnostic of acute cholecystitis include:
**No visualization of the gallbladder
***No visualization of the [[gallbladder]]
*
===Advantages of cholescintigraphy===
**Superior sensitivity to ultrasound
*Advantages of [[cholescintigraphy]] include:<ref name="pmid24679431">{{cite journal |vauthors=Knab LM, Boller AM, Mahvi DM |title=Cholecystitis |journal=Surg. Clin. North Am. |volume=94 |issue=2 |pages=455–70 |year=2014 |pmid=24679431 |doi=10.1016/j.suc.2014.01.005 |url=}}</ref>
**Superior sensitivity to [[ultrasound]]
 
===Limitations of cholescintigraphy===
*Limitations of [[cholescintigraphy]] include:<ref name="pmid24679431">{{cite journal |vauthors=Knab LM, Boller AM, Mahvi DM |title=Cholecystitis |journal=Surg. Clin. North Am. |volume=94 |issue=2 |pages=455–70 |year=2014 |pmid=24679431 |doi=10.1016/j.suc.2014.01.005 |url=}}</ref>
**Expensive
**Time consuming
**Radiation exposure
**Requires skilled staff
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|background: "#FFFFFF;" |[[File:HIDA.jpg|400px|thumb|center|Normal hepato-billiary scan; Cholescintigraphy (HIDA scan). <small> By Myohan at en.wikipedia, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=17269984 Source:<ref name="urlCholescintigraphy - Wikipedia">{{cite web |url=https://en.wikipedia.org/wiki/Cholescintigraphy |title=Cholescintigraphy - Wikipedia |format= |work= |accessdate=}}</ref>]]
|
<br clear="left" />
|}


(see Fig. 3B). The main advantage of HIDA is its superior sensitivity in diagnosing acute cholecystitis. However, there are several disadvantages. Compared with US, cholescintigraphy is more expensive, time intensive (it takes several hours compared with 10–15 minutes for US), requires skilled staff, and is often not available after hours. It also exposes patients to ionizing radiation and provides information limited to the hepatobiliary system, whereas US and MRI do not expose patients to radiation and can provide added information outside the hepatobiliary system.
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2]

Overview

Cholescintigraphy is the gold standard for the diagnosis of acute cholecystitis. Cholescintigraphy is an alternative method of imaging and uses technetium-labeled hepatic 2,6-dimethyl-iminodiacetic acid (HIDA) in difficult cases or uncertain diagnosis. Findings on a cholescintigraphy diagnostic of acute cholecystitis include lack of visualization of the gallbladder.

Other Imaging Findings

Advantages of cholescintigraphy

Limitations of cholescintigraphy

  • Limitations of cholescintigraphy include:[1]
    • Expensive
    • Time consuming
    • Radiation exposure
    • Requires skilled staff
Normal hepato-billiary scan; Cholescintigraphy (HIDA scan). By Myohan at en.wikipedia, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=17269984 Source:[5]


References

  1. ↑ 1.0 1.1 1.2 Knab LM, Boller AM, Mahvi DM (2014). "Cholecystitis". Surg. Clin. North Am. 94 (2): 455–70. doi:10.1016/j.suc.2014.01.005. PMID 24679431.
  2. ↑ Gomes CA, Junior CS, Di Saverio S, Sartelli M, Kelly MD, Gomes CC, Gomes FC, Corrêa LD, Alves CB, Guimarães SF (2017). "Acute calculous cholecystitis: Review of current best practices". World J Gastrointest Surg. 9 (5): 118–126. doi:10.4240/wjgs.v9.i5.118. PMC 5442405. PMID 28603584.
  3. ↑ Kiewiet JJ, Leeuwenburgh MM, Bipat S, Bossuyt PM, Stoker J, Boermeester MA (2012). "A systematic review and meta-analysis of diagnostic performance of imaging in acute cholecystitis". Radiology. 264 (3): 708–20. doi:10.1148/radiol.12111561. PMID 22798223.
  4. ↑ "Imaging of Cholecystitis : American Journal of Roentgenology : Vol. 196, No. 4 (AJR)".
  5. ↑ "Cholescintigraphy - Wikipedia".

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