title: Evaluation of power Doppler sonography in acute cholecystitis to predict intraoperative findings: a prospective clinical study.
abstract: BACKGROUND
  This study aimed to evaluate the diagnostic value of gray-scale and power Doppler sonography for acute cholecystitis and show a correlation between sonographic and intraoperative findings, quantitively.
  
  
  METHODS
  Forty chronic and forty acute cholecystitis patients were examined. Early laparoscopic cholecystectomy was performed for acute cholecystitis. Demographic characteristics, sonographic findings, and adhesion scores were analyzed. Data were collected prospectively (clinicaltrials.gov: NCT02156947).
  
  
  RESULTS
  Wall thickness (≥3 mm) and vascularity increased in acute cholecystitis (p<0.01 and <0.01). Vascularity was found to be moderately correlated with adhesion (p<0.01, r=0.59) but it did not affect the difficulty of the operation by means of perforation, conversion rate, and operation time. In addition, wall thickness did not correlate with adhesion formation (p=0.36). Sensitivity and specifity of wall thickness and vascularity were found to be 96.9%, 72.7%, and 68%, 87.2%, respectively. When both diagnostic measurements were taken into account, sensitivity was calculated 69.7% and specificity reached up to 97.6%.
  
  
  CONCLUSIONS
  Vascularity correlated with adhesion but failed to predict operation difficulty. Specificity of gray-scale sonography could be improved with power Doppler examination; however, desired diagnostic accuracy could not be obtained with only quantitive measurements of sonography.
authors.affiliation: Department of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Süleyman
authors.initials: S
authors.lastname: Çetinkünar
authors.affiliation: Department of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Erdem
authors.affiliation: Department of General Surgery, Samsun Training and Research Hospital, Adana, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Aktimur
authors.affiliation: Department of Radiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Soker
authors.affiliation: Department of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Hilmi
authors.initials: H
authors.lastname: Bozkurt
authors.affiliation: Department of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Enver
authors.initials: E
authors.lastname: Reyhan
authors.affiliation: Department of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Sozen
authors.affiliation: Department of General Surgery, Adana Numune Training and Research Hospital, Adana.
authors.forename: Oktay
authors.initials: O
authors.lastname: İrkorucu
mesh_terms: D041881:Cholecystitis, Acute / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018608:Ultrasonography, Doppler / Q000379:methods*