title: The Diagnosis of Acute Cholecystitis: Sensitivity of Sonography, Cholescintigraphy and Computed Tomography.
abstract: OBJECTIVE
  To compare the sensitivity of sonographic, cholescintigraphic, and computed tomographic examination of acute cholecystitis to the pathology result, which is considered the Gold Standard.
  
  
  METHODS
  A retrospective analytic study was conducted among 412 patients, aged between 15 and 98 years, who underwent cholecystectomy surgeries, and whose pathology results indicated acute cholecystitis between July 2004 and May 2013. The sensitivity and the differences between sensitivity of the three methods were calculated in all patients. Complicated acute cholecystitis cases were analyzed separately.
  
  
  RESULTS
  The three methods demonstrated statistically significant differences in sensitivity (p-value = 0.017), with the cholescintigraphy as the most sensitive method (84.2%), followed by computed tomography (67.3%), and sonography (59.8%). Concerning the samples with the pathology result indicating complicated acute cholecystitis, computed tomography was statistically significantly more sensitive than sonography in detecting acute cholecystitis, whether or not the complications were identified (100% and 63.6%, respectively, with p-value = 0.0055). None of the patients with the pathology result of complicated acute cholecystitis case was examined by cholescintigraphy, thus, no calculation was possible. Regarding the ability to detect the complications of acute cholecystitis, computed tomography had a sensitivity of 35.71% (5 in 14 patients), while sonographic examinations could not detect any of the complications.
  
  
  CONCLUSIONS
  Cholescintigraphy is a more sensitive method than computed tomography and sonography, but the three methods have its own advantages, disadvantages, and limitations, which must be consideredfor each individual patient.
authors.forename: Patthisak
authors.initials: P
authors.lastname: Changphaisarnkul
authors.forename: Supakajee
authors.initials: S
authors.lastname: Saengruang-Orn
authors.forename: Trirat
authors.initials: T
authors.lastname: Boonya-Asadorn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D041881:Cholecystitis, Acute / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult