Clinical implications of hepatobiliary scintigraphy and ultrasound in the diagnosis of acute cholecystitis

Rodríguez, Limael E.; Santaliz-Ruiz, Luis E.; Torre-Bisot, Gabriel De La; González, Giovanni; Serpa, Miguel A.; Sanchez-Gaetan, Felipe; Martínez-Trabal, Jorge L.; Peguero-Rivera, Julio A.; Bolaños-Ávila, Guillermo

doi:10.1016/j.ijsu.2016.09.084

Cited by 25 publications

(11 citation statements)

References 9 publications

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“…HIDA scanning has sensitivities ranging from 91% to 92% compared with US, which has sensititives ranging from 26% to 73%. HIDA scanning has a specificity of 71%-79% compared with US, which has a specificity of 58%-80% (47)(48)(49).…”

Section: Acute Cholecystitismentioning

confidence: 99%

Multimodality Imaging, including Dual-Energy CT, in the Evaluation of Gallbladder Disease

et al. 2018

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Imaging of the gallbladder has a key role in the examination of patients with abdominal pain-especially pain localized to the right upper quadrant. Pathologic conditions that affect the gallbladder include cholelithiasis and associated complications such as acute and chronic cholecystitis, choledocholithiasis, gallstone pancreatitis, and cancer. Modalities used to image the gallbladder include ultrasonography (US), computed tomography (CT), magnetic resonance (MR) imaging, and nuclear scintigraphy. US is the primary imaging modality used to evaluate entities suspected of being gallbladder disease, as it is both sensitive and specific for demonstrating gallstones, biliary duct dilatation, and inflammatory features. However, CT is often the first imaging examination performed in patients who present to the emergency department with acute abdominal pain. Because the CT appearance of gallstones is variable, depending on the composition of the stone, pattern of calcification, and presence of gas, gallstones and other gallbladder conditions can be difficult to detect at conventional multidetector CT, with which data are acquired by using a single x-ray energy spectrum. Dual-energy CT, with which one takes advantage of the material-dependent x-ray absorption behavior of concurrently acquired high- and low-kilovolt-peak data, can add value by increasing the conspicuity of noncalcified gallstones and improving the detection of acute cholecystitis and gallbladder malignancy. In addition, MR cholangiopancreatography can be helpful for assessing choledocholithiasis and complicated biliary duct disease. RSNA, 2018.

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Section: Acute Cholecystitismentioning

confidence: 99%

Multimodality Imaging, including Dual-Energy CT, in the Evaluation of Gallbladder Disease

et al. 2018

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“…The use of US in acute cholecystitis has been well reported, and its ease of use and non‐invasive modality have been described in case series studies . However, the diagnostic yield described in those articles varies according to the device, assessment criteria, and diagnostic criteria used in each of the studies, all of which were of small numbers of patients in single institutions.…”

Section: Introductionmentioning

confidence: 99%

“…However, the diagnostic yield described in those articles varies according to the device, assessment criteria, and diagnostic criteria used in each of the studies, all of which were of small numbers of patients in single institutions. All studies that have compared the diagnostic yield of hepatobiliary scintigraphy (HIDA scanning) with that of US have found that the diagnostic yield is higher for HIDA scanning , but diagnostic imaging with US is nevertheless recommended in three newly proposed guidelines despite its limited diagnostic yield .…”

Section: Introductionmentioning

confidence: 99%

Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos)

Yokoe

Hata

Takada

et al. 2018

J Hepato Biliary Pancreat

933

605

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The Tokyo Guidelines 2013 (TG13) for acute cholangitis and cholecystitis were globally disseminated and various clinical studies about the management of acute cholecystitis were reported by many researchers and clinicians from all over the world. The 1 st edition of the Tokyo Guidelines 2007 (TG07) was revised in 2013. According to that revision, the TG13 diagnostic criteria of acute cholecystitis provided better specificity and higher diagnostic accuracy. Thorough our literature search about diagnostic criteria for acute cholecystitis, new and strong evidence that had been released from 2013 to 2017 was not found with serious and important issues about using TG13 diagnostic criteria of acute cholecystitis. On the other hand, the TG13 severity grading for acute cholecystitis has been validated in numerous studies. As a result of these reviews, the TG13 severity grading for acute cholecystitis was significantly associated with parameters including 30-day overall mortality, length of hospital stay, conversion rates to open surgery, and medical costs. In terms of severity assessment, breakthrough and intensive literature for revising severity grading was not reported. Consequently, TG13 diagnostic criteria and severity grading were judged from numerous validation studies as useful indicators in clinical practice and adopted as TG18/TG13 diagnostic criteria and severity grading of acute cholecystitis without any modification. Free full articles and mobile app of TG18 are available at: http:// www.jshbps.jp/modules/en/index.php?content_id=47. Related clinical questions and references are also included.

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“…We designed our RIP after a thorough review of our historical data, in which we looked at the diagnostic performance of ultrasound for AC, perioperative data, and quality outcomes. For the latter study, we found that not only was US underperforming (sensitivity 26% for AC) but our classic approach was associated with delayed treatment [ 9 ]. However, the latter findings could not be attributed to poor management.…”

Section: Discussionmentioning

confidence: 99%

“…The features of the clinical feature score were determined by multivariate analysis of all presenting baseline clinical and laboratory findings in the historical group (n = 117). The details of this analysis have been previously described [ 9 ]. When all presenting features were analyzed, WBC count ≥10,000 (10 9 /L), glucose ≥140 (mg/dl), and age ≥50 years were the three presenting features that had a statically significant positive association with pathologically confirmed acute cholecystitis.…”

Section: Methodsmentioning

confidence: 99%

The impact of a rapid imaging protocol in acute cholecystitis-prospective cohort study

Rodríguez

Sanchez-Vivaldi

Velez-Quiñones

et al. 2018

International Journal of Surgery Case Reports

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HighlightsA rapid imaging protocol with defined clinical criteria for acute cholecystitis (AC) resulted in significant improvements in perioperative and quality measures.Acute on chronic cholecystitis (ACC) may present with typical and/or atypical clinical features of AC, and was the most common pathology found in our specimens for the RIP.HIDA and CT scan had similar performance for de novo AC. However, diagnostic performance for both studies was reduced in the setting of ACC.Delayed filling of the gallbladder on HIDA in a patient with high risk features is ACC until proven otherwise, and urgent cholecystectomy should be considered.

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Clinical implications of hepatobiliary scintigraphy and ultrasound in the diagnosis of acute cholecystitis

Cited by 25 publications

References 9 publications

Multimodality Imaging, including Dual-Energy CT, in the Evaluation of Gallbladder Disease

Multimodality Imaging, including Dual-Energy CT, in the Evaluation of Gallbladder Disease

Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos)

The impact of a rapid imaging protocol in acute cholecystitis-prospective cohort study

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