Accuracy of Imaging Methods for Diagnosing Acute Cholecystitis

I.Yu. Skyrda, V.М. Gladun, О.V. Zakrevska

Abstract


The study was conducted to evaluate the diagnostic accuracy for acute cholecystitis, acute cholangitis and to get summary data. Information search of results of clinical trials, systematic reviews, meta-analysis, clinical guidelines regarding the sensitivity and specificity of hepatobiliary scintigraphy, US, MR, , CT scanning in acute cholangitis was conducted in Cochranelibrary, Medline/PubMed and other search systems by key words: gallstone disease, acute cholecystitis, ultrasonography , cholescintigraphy, computer tomography, magnetic resonance tomography, sensitivity, specificity from January 2000 to February 2014. Inclusion criteria: a) clear criteria for determining a positive result visualization, b) operation and/or clinical observations were used as a reference, and c) there are enough data to estimate the number of true positive, negative results, false-positive and false-negative results.
In a study evaluating hepatobiliary scintigraphy sensitivity of 88.5 % (95% CI: 81–97 %) and specificity of 91.8 % (95% CI: 86–93 %) were comparable with the data of 2012, but slightly lower sensitivity was revealed in our study. Sensitivity was 84.4 % (95% CI: 76–93 %) with specificity of 85.1 % (95% CI: 78–91 %) for studies evaluatining ultrasonography, which is slightly higher than those obtained in a systematic survey in 2012. We have shown that magnetic resonance imaging and ultrasonography did not reveal statistically significant differences in the diagnosis of gallbladder wall thickening, presence of gallstones, pericholesistic liquid or acute cholecystitis (p > 0.05). Sensitivity of acute cholecystitis comprised 89.4 % (95% CI: 85–91 %) and specificity was 87.2 % (95% CI: 83–99 %) for magnetic resonance imaging. This method is equal to ultrasonography in the diagnosis of cholelithiasis disease, gallbladder wall thickening, determining the presence of pericholesistic edema and acute cholecystitis in patients with acute pain symptoms in the right upper abdominal quadrant. Especially in patients with sonographic complexity magnetic resonance imaging can be used as a quick and easy method of diagnosis.


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DOI: https://doi.org/10.22141/2308-2097.1.55.2015.80350

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