Highlights
- •Multiple imaging studies including MRI, CT and ultrasound may be obtained during evaluation of acute cholecystitis.
- •Direct size measurements of most structures can be obtained be each of these studies.
- •The measurements obtained from one imaging study are nearly identical to other imaging studies.
- •Additional imaging studies should not be obtained while evaluating acute cholecystitis for biliary system measurements.
Abstract
Background
Patients with right upper quadrant pain are often imaged using multiple modalities
with no established gold standard. A single imaging study should provide adequate
information for diagnosis.
Methods
A multicenter study of patients with acute cholecystitis was queried for patients
who underwent multiple imaging studies on admission. Parameters were compared across
studies including wall thickness (WT), common bile duct diameter (CBDD), pericholecystic
fluid and signs of inflammation. Cutoff for abnormal values were 3 mm for WT and 6 mm
for CBDD. Parameters were compared using chi-square tests and Intra-class correlation
coefficients (ICC).
Results
Of 861 patients with acute cholecystitis, 759 had ultrasounds, 353 had CT and 74 had
MRIs. There was excellent agreement for wall thickness (ICC = 0.733) and bile duct
diameter (ICC = 0.848) between imaging studies. Differences between wall thickness
and bile duct diameters were small with nearly all <1 mm. Large differences (>2 mm)
were rare (<5%) for WT and CBDD.
Conclusions
Imaging studies in acute cholecystitis generate equivalent results for typically measured
parameters.
Keywords
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Article info
Publication history
Published online: February 23, 2023
Accepted:
February 23,
2023
Received in revised form:
February 21,
2023
Received:
December 26,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
