title: Accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis: review of the literature.
abstract: BACKGROUND
  To evaluate the accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis in comparison with other imaging modalities.
  
  
  METHODS
  The authors performed a search of the Medline/ PubMed (National Library of Medicine, Bethesda, Maryland) for original research and review publications examining the accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis. The search design utilized a single or combination of the following terms : (1) acute cholecystitis, (2) ultrasonography, (3) computed tomography, (4) magnetic resonance cholangiopancreatography and (5) cholescintigraphy. This review was restricted to human studies and to English-language literature. Four authors reviewed all the titles and subsequent the abstract of 198 articles that appeared appropriate. Other articles were recognized by reviewing the reference lists of significant papers. Finally, the full text of 31 papers was reviewed.
  
  
  RESULTS
  Sonography is still used as the initial imaging technique for evaluating patients with suspected acute calculous cholecystitis because of its high sensitivity at the detection of GB stones, its real-time character, and its speed and portability. Cholescintigraphy still has the highest sensitivity and specificity in patients who are suspected of having acute cholecystitis. However, due to a combination of reasons including logistic drawbacks, broad imaging capability and clinician referral pattern the use of cholescintigraphy is limited in clinical practice. CT is particularly useful for evaluating the many complications of acute calculous cholecystitis. The lack of widespread availability of MRI and the relatively high cost prohibits its primary use in patients with acute calculous cholecystitis.
  
  
  CONCLUSIONS
  US is currently considered the preferred initial imaging technique for patients who are clinically suspected of having acute calculous cholecystitis.
authors.affiliation: Department of Diagnostic Imaging, A, Cardarelli Hospital, Naples, Italy. antopin1968@libero.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pinto
authors.forename: Alfonso
authors.initials: A
authors.lastname: Reginelli
authors.forename: Lucio
authors.initials: L
authors.lastname: Cagini
authors.forename: Francesco
authors.initials: F
authors.lastname: Coppolino
authors.forename: Antonio Amato
authors.initials: AA
authors.lastname: Stabile Ianora
authors.forename: Renata
authors.initials: R
authors.lastname: Bracale
authors.forename: Melchiore
authors.initials: M
authors.lastname: Giganti
authors.forename: Luigia
authors.initials: L
authors.lastname: Romano
references.citation: World J Surg. 1992 Nov-Dec;16(6):1160-5; discussion 1166
references.pmid: 1455890
references.citation: Semin Roentgenol. 2001 Apr;36(2):81-91
references.pmid: 11329660
references.citation: AJR Am J Roentgenol. 2007 Feb;188(2):495-501
references.pmid: 17242260
references.citation: Radiology. 1981 Aug;140(2):449-55
references.pmid: 7255722
references.citation: Clin Radiol. 1999 Sep;54(9):588-94
references.pmid: 10505994
references.citation: Radiographics. 2007 Mar-Apr;27(2):477-95
references.pmid: 17374864
references.citation: J Comput Assist Tomogr. 1998 Jul-Aug;22(4):638-42
references.pmid: 9676460
references.citation: Abdom Imaging. 1996 May-Jun;21(3):233-7
references.pmid: 8661555
references.citation: Abdom Imaging. 2003 Sep-Oct;28(5):643-51
references.pmid: 14628868
references.citation: Radiology. 1985 Jun;155(3):767-71
references.pmid: 3890007
references.citation: Semin Ultrasound CT MR. 2012 Aug;33(4):308-17
references.pmid: 22824121
references.citation: Australas Radiol. 2002 Dec;46(4):438-40
references.pmid: 12452921
references.citation: Acta Radiol. 2002 Jan;43(1):77-9
references.pmid: 11972467
references.citation: JAMA. 2003 Jan 1;289(1):80-6
references.pmid: 12503981
references.citation: Radiology. 2008 Jun;247(3):912; author reply 912-3
references.pmid: 18487545
references.citation: Radiology. 2012 Sep;264(3):708-20
references.pmid: 22798223
references.citation: AJR Am J Roentgenol. 2011 Apr;196(4):W367-74
references.pmid: 21427298
references.citation: J Pediatr Surg. 2011 May;46(5):1015-8
references.pmid: 21616273
references.citation: Radiology. 1998 Dec;209(3):781-5
references.pmid: 9844674
references.citation: Radiographics. 2000 May-Jun;20(3):751-66
references.pmid: 10835126
references.citation: Arch Intern Med. 1994 Nov 28;154(22):2573-81
references.pmid: 7979854
references.citation: Radiol Clin North Am. 2008 Jul;46(4):755-71, vi
references.pmid: 18922291
references.citation: Acta Radiol. 2000 Jul;41(4):322-8
references.pmid: 10937751
references.citation: AJR Am J Roentgenol. 1994 May;162(5):1105-8
references.pmid: 8165991
references.citation: Recenti Prog Med. 2012 Nov;103(11):493-9
references.pmid: 23096738
references.citation: J Hepatol. 2008 May;48(5):811-20
references.pmid: 18321607
references.citation: Eur J Radiol. 2008 May;66(2):246-52
references.pmid: 17629431