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Cystic artery velocity as a predictor of acute cholecystitis.
Perez, Marcelina G; Tse, Justin R; Bird, Kristen N; Liang, Tie; Brooke Jeffrey, R; Kamaya, Aya.
Afiliación
  • Perez MG; Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Room H-1307, Stanford, CA, 94305, USA.
  • Tse JR; Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA.
  • Bird KN; Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Room H-1307, Stanford, CA, 94305, USA.
  • Liang T; Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Room H-1307, Stanford, CA, 94305, USA.
  • Brooke Jeffrey R; Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Room H-1307, Stanford, CA, 94305, USA.
  • Kamaya A; Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Room H-1307, Stanford, CA, 94305, USA. kamaya@stanford.edu.
Abdom Radiol (NY) ; 46(10): 4720-4728, 2021 10.
Article en En | MEDLINE | ID: mdl-34216245
PURPOSE: To evaluate angle-corrected peak systolic cystic artery velocity (CAv) as a predictor of acute cholecystitis among patients presenting to the emergency department (ED) with right upper quadrant (RUQ) pain. METHODS: In this IRB-approved and retrospective study, CAv was evaluated in 73 patients, 43 who underwent definitive treatment with cholecystectomy or percutaneous cholecystostomy and 30 control patients without clinical suspicion for cholecystitis. In addition to CAv, the following were reviewed by 3 radiologists: CBD diameter, cholelithiasis, impacted stone in the neck, sludge, gallbladder wall thickness > 3 mm, gallbladder transverse dimension ≥ 4 cm, longitudinal dimension ≥ 8 cm, tensile gallbladder fundus sign, pericholecystic fluid, pericholecystic echogenic fat, and sonographic Murphy sign. RESULTS: Of the 43 patients who underwent definitive treatment, 25 had acute cholecystitis (34%) and 18 (25%) had chronic cholecystitis. Average CAv measurements were 50 ± 16 cm/s (acute), 28 ± 8 cm/s (chronic), and 22 ± 8 cm/s (control; p < 0.0001). In univariate analysis, among patients who underwent definitive therapy, CAv ≥ 40 cm/s, gallbladder wall thickness, stone impaction, GB long dimension ≥ 8 cm, and elevated WBC were associated with acute cholecystitis (p < 0.05). In multivariate analysis, CAv ≥ 40 cm/s was the only statistically significant variable (p = 0.016). CAv ≥ 40 cm/s alone had a PPV of 94.7% and overall accuracy of 81.4% in diagnosing acute cholecystitis. CONCLUSION: CAv ≥ 40 cm/s is highly associated with acute cholecystitis in patients presenting to the ED with RUQ pain.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colecistitis / Colecistitis Aguda Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Abdom Radiol (NY) Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colecistitis / Colecistitis Aguda Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Abdom Radiol (NY) Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos