title: Hepatobiliary scintigraphy is superior to abdominal ultrasonography in suspected acute cholecystitis.
abstract: BACKGROUND
  Hepatobiliary scintigraphy is a very accurate test in the diagnosis of acute cholecystitis. However, ultrasonography is extensively used for the diagnosis of this disease. In this study, we directly compare the diagnostic accuracy of these techniques for acute cholecystitis.
  
  
  METHODS
  The diagnostic accuracy of scintigraphy and ultrasonography was evaluated in 107 consecutive patients with suspected acute cholecystitis who underwent both imaging modalities within one day. The incremental diagnostic value of each modality was determined.
  
  
  RESULTS
  The sensitivity, specificity, positive and negative predictive values, and accuracy for the diagnosis of acute cholecystitis in the entire cohort were superior for scintigraphy compared with ultrasonography. The accuracy was 92% for scintigraphy and 77% for ultrasonography. Similarly, if only surgically treated patients were considered, the accuracy of scintigraphy was 91% versus 61% for ultrasonography. The diagnostic value of scintigraphy for the entire cohort was significantly superior to ultrasonography (global, chi(2) = 58.1 vs 9.7, respectively); the addition of the information derived from the latter did not further improve the diagnostic value of scintigraphy (global, chi(2) = 58.2).
  
  
  CONCLUSIONS
  Hepatobiliary scintigraphy has superior diagnostic accuracy for acute cholecystitis compared with ultrasonography. The addition of ultrasonography does not further improve the diagnostic accuracy of scintigraphy alone.
authors.affiliation: Department of Radiology/Nuclear Medicine Section, Baylor College of Medicine, St. Luke's Episcopal Hospital, Houston, TX 77030, USA.
authors.forename: S N
authors.initials: SN
authors.lastname: Chatziioannou
authors.forename: W H
authors.initials: WH
authors.lastname: Moore
authors.forename: P V
authors.initials: PV
authors.lastname: Ford
authors.forename: R D
authors.initials: RD
authors.lastname: Dhekne
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001659:Biliary Tract / Q000000981:diagnostic imaging; D002764:Cholecystitis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D019785:Technetium Tc 99m Disofenin; D014463:Ultrasonography
chemical_list: D019785:Technetium Tc 99m Disofenin