Chronic cholecystitis CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

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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

  • CT scan is more specific than ultrasound.
  • CT scan findings include[1]
    • Gall bladder wall thickening
    • Gall bladder distension
    • Pericholecystic fat density
    • Pericholecystic fluid collection
    • Subserosal edema
    • High attenuation gallbladder bile
  • CT cannot see noncalcified gallbladder calculi, and cannot assess for a Murphy's sign. [2] [3]

CT demonstrates findings that are consistent with acute cholecystitis (gallstone in GB neck, pericholicystic fluid, GB wall thickening)

References

  1. 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)
  2. 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.
  3. 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.

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