Acute Cholecystitis: Comparison of Clinical Findings from Ultrasound and Computed Tomography

Abstract

Acute cholecystitis is a common surgical emergency, for which ultrasound (US) is the most common first-line diagnostic imaging test. Computed tomography (CT) is an alternative or complementary test for the assessment of acute cholecystitis. Acute cholecystitis is diagnosed based on clinical history and assessment, biochemical examination, and US findings. CT is considered only in case of unclear clinical symptoms or discrepant findings. We aimed to retrospectively compare the efficiency of CT and sonography for the diagnosis of acute cholecystitis in 103 patients who underwent laparoscopic cholecystectomy for acute cholecystitis during 2009-2018. The sensitivity and specificity of US and CT were comparatively analyzed on the basis of the intraoperative findings and histological outcomes. All patients underwent US and CT, of which 60 were diagnosed with acute cholecystitis based on histopathology. US and CT demonstrated 100% and 100% specificity, 77% and 77% negative predictive value (NPV), and 72% and 85% sensitivity for the diagnosis of acute cholecystitis, respectively. Thus, CT revealed a higher degree of sensitivity for acute cholecystitis diagnosis. However, US remain the first choice of test for diagnosis.

Accuracy of Ultrasound and Computed Tomography in Diagnosing Acute Cholecystitis Patients in a Tertiary Care Center in Saudi Arabia

“…This finding appears to be similar to a previous study that found that the sensitivity of CT was significantly greater than US for detecting AC (85% versus 68%) [26]. When compared to the recent literature, Oda et al reported that CT had more sensitivity than US (85% versus 72%) [24]. Additionally, consistent with our results, Compared to US, CT was more sensitive (79% versus 92%) [27].…”

“…Therefore, US had a higher sensitivity than the CT scan but a lower specificity [6]. In addition, multiple studies found that CT is superior to US in diagnosing cholecystitis in adult patients undergoing emergency evaluation for RUQ pain and has the advantage of depicting acute non-gallbladder abnormalities [23][24][25]. Another study reported that US in pediatric patients with cholecystitis is less sensitive than in adults [21].…”