Philippe Soyer1, Christine Hoeffel2, Anthony Dohan3, Etienne Gayat4, Clarisse Eveno5, Brice Malgras6, Karine Pautrat6, Mourad Boudiaf7. 1. Department of Abdominal Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris Université Paris-Diderot, Sorbonne Paris Cité, Paris INSERM, U 965, Paris Cedex 10 philippe.soyer@lrb.aphp.fr. 2. Department of Radiology, Hôpital Robert Debré, Reims. 3. Department of Abdominal Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris INSERM, U 965, Paris Cedex 10. 4. Université Paris-Diderot, Sorbonne Paris Cité, Paris Department of Anesthesiology and Intensive Care Medicine, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris. 5. INSERM, U 965, Paris Cedex 10 Surgical Oncologic & Digestive Unit, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France. 6. Surgical Oncologic & Digestive Unit, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France. 7. Department of Abdominal Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris.
Abstract
BACKGROUND: Because of an expanded role for CT in the evaluation of patients with acute abdominal pain, it is not rare that acute cholecystitis is depicted by CT. However, the sensitivity and the specificity of a given CT variable for the diagnosis of acute cholecystitis is not known. PURPOSE: To quantitatively and qualitatively analyze acute cholecystitis at 64-section helical CT with submilimeter and isotropic voxels using a retrospective case-control study. MATERIAL AND METHODS: The 64-section helical CT examinations obtained with submilimeter and isotropic voxels in 40 patients with acute cholecystitis (25 men; mean age, 62.2 years) were quantitatively and qualitatively analyzed and compared to those of 40 control subjects matched for age and gender. Receiver-operating characteristic (ROC) curve analysis was used to determine the most discriminating cut-off values for quantitative variables. Comparisons of qualitative variables were made using univariate analysis. RESULTS: Pericholecystic fat stranding, mural stratification, pericholecystic hypervascularity, spontaneous hyperattenuation of gallbladder wall, short (≥ 32-mm) and long (≥ 74-mm) gallbladder axis enlargement, and gallbladder wall thickening (≥ 3.6-mm) were the most discriminating and independent variables for the diagnosis of acute cholecystitis (P < 0.0001). Using cut-off values found at ROC curve analysis, gallbladder wall thickening, and short and long gallbladder axis enlargement were the most sensitive findings (sensitivity = 92.5%; 95%CI: 79.6%-98.4%) for the diagnosis of acute cholecystitis. CONCLUSION: Acute cholecystitis is associated with myriad suggestive findings on 64-section helical CT. It can be anticipated that familiarity with these findings would result in more confident diagnosis of acute cholecystitis at 64-section helical CT.
BACKGROUND: Because of an expanded role for CT in the evaluation of patients with acute abdominal pain, it is not rare that acute cholecystitis is depicted by CT. However, the sensitivity and the specificity of a given CT variable for the diagnosis of acute cholecystitis is not known. PURPOSE: To quantitatively and qualitatively analyze acute cholecystitis at 64-section helical CT with submilimeter and isotropic voxels using a retrospective case-control study. MATERIAL AND METHODS: The 64-section helical CT examinations obtained with submilimeter and isotropic voxels in 40 patients with acute cholecystitis (25 men; mean age, 62.2 years) were quantitatively and qualitatively analyzed and compared to those of 40 control subjects matched for age and gender. Receiver-operating characteristic (ROC) curve analysis was used to determine the most discriminating cut-off values for quantitative variables. Comparisons of qualitative variables were made using univariate analysis. RESULTS: Pericholecystic fat stranding, mural stratification, pericholecystic hypervascularity, spontaneous hyperattenuation of gallbladder wall, short (≥ 32-mm) and long (≥ 74-mm) gallbladder axis enlargement, and gallbladder wall thickening (≥ 3.6-mm) were the most discriminating and independent variables for the diagnosis of acute cholecystitis (P < 0.0001). Using cut-off values found at ROC curve analysis, gallbladder wall thickening, and short and long gallbladder axis enlargement were the most sensitive findings (sensitivity = 92.5%; 95%CI: 79.6%-98.4%) for the diagnosis of acute cholecystitis. CONCLUSION:Acute cholecystitis is associated with myriad suggestive findings on 64-section helical CT. It can be anticipated that familiarity with these findings would result in more confident diagnosis of acute cholecystitis at 64-section helical CT.