Chronic cholecystitis CT
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2], Furqan M M. M.B.B.S[3]
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Overview
The reported sensitivity and specificity of CT scan findings are in the range of 90-95%. CT is more sensitive than ultrasonography in the depiction of pericholecystic inflammatory response and in localizing pericholecystic abscesses, pericholecystic gas, and calculi outside the lumen of the gallbladder.
CT scan
- CT scan is more specific than ultrasound. CT scan findings include:[1][2]
- Gallbladder wall thickening
- Gallbladder distension or contraction
- Subserosal edema
- High attenuation gallbladder bile
- CT cannot identify noncalcified gallbladder calculi, and cannot assess for Murphy's sign.[3][4]
Acalculous Cholecystitis
The CT based diagnostic criteria from multiple studies for acalculous cholecystits is as follows.[5]
| Criteria | Diagnosis |
|---|---|
| Major | 3 to 4 mm wall thickness Pericholecystic fluid Subserosal edema Intramural gas Sloughed mucosa |
| Minor | Hyperdense bile (sludge) Subjective distension (hydrops) |
Diagnosis: 2 major or 1 major and 2 minor
References
- ↑ 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.
- ↑ Fidler J, Paulson EK, Layfield L (1996). "CT evaluation of acute cholecystitis: findings and usefulness in diagnosis". AJR. American Journal of Roentgenology. 166 (5): 1085–8. PMID 8615248. Retrieved 2012-08-20. Unknown parameter
|month=ignored (help) - ↑ 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)