Does the correlation of acute cholecystitis on ultrasound and at surgery reflect a mirror image?
BACKGROUND
It remains unclear if sonography accurately describes the severity of gallstone disease.


METHODS
Patients were prospectively enrolled if urgent cholecystectomy was indicated. Two radiologists, blinded to operative findings, evaluated the patients' ultrasound imagings. Laparoscopic cholecystectomy was performed within 48 hours. The operative findings regarding gallbladder wall thickness and inflammation were compared to ultrasound results and histology.


RESULTS
Fifty-five patients completed the study. Ultrasound studies exhibited a sensitivity of 60% for the diagnosis of acute cholecystitis compared to the findings at operation and 52% relative to the histologic findings. Specificity for acute cholecystitis diagnosed on ultrasound examination was 77% compared to findings at operation and 71% relative to histologic findings. The correlation coefficient of the wall thickness at ultrasound and surgery was 0.18: 0.24 for ultrasound and histology and 0.5 for surgery and histology.


CONCLUSIONS
Ultrasound's ability to predict acute cholecystitis in patients with clinical symptoms appears limited.
Bingener
Juliane
J
Department of Surgery, University of Texas Health Science Center at San Antonio, Mail Code 7842, 7703 Floyd Curl Dr., San Antonio, TX 78229-3900, USA. bingenercas@uthscsa.edu
Schwesinger
Wayne H
WH
Chopra
Shailandra
S
Richards
Melanie L
ML
Sirinek
Kenneth R
KR
D000293:Adolescent; D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D041881:Cholecystitis, Acute / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler