Accuracy of ultrasound in counting and measuring gallstones

Bret, Patrice M.; Cordovez-Stanziola, Rosana; Atri, Mostafa; Illescas, Fernando F.; Aldis, Ann; Herschorn, Sally D.

doi:10.1007/bf01887377

“…6 after diagnosis, 40 (71.4%) patients were without sludge and showed normal gallbladder findings (Fig. 2).…”

Section: Resultsmentioning

confidence: 84%

“…Because of all the advantages connected with the method and a sensitivity of more than 95%, together with an approximately 99% specificity, no other diagnostic method can at present compete with abdominal sonography with regard to the detection of gallbladder stones. Sonography's sensitivity is 15% to 20% better than that routinely reported for cholecystography, and patients are not exposed to either radiation or iodine (1)(2)(3)(4)(5)(6). The reliability in the gallstone diagnosis above all depends on the experience of the investigator.…”

Section: )mentioning

confidence: 94%

Gallbladder sludge: Spontaneous course and incidence of complications in patients without stones

Janowitz

¹

,

Kratzer

²

,

Zemmler

³

et al. 1994

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Although the ultrasonic detection of gallbladder sludge is relatively frequent, its clinical importance remains unclear, partly because of the paucity of reliable investigations regarding its natural course in patients without stones. In a retrospective study we investigated the course and clinical significance of gallbladder sludge in patients without stones or other identified gallbladder abnormalities. The diagnosis of gallbladder sludge was made by ultrasound scan in 286 (1.7%) of 17,021 patients. The mean follow-up period for these patients was 20.3 +/- 11.5 mo. Of this group 56 patients were without both stones and sludge at the initial examination, and gallbladder sludge developed after a mean observation period of 11.2 +/- 10.6 mo. Within 2.0 +/- 3.5 mo after sludge detection, 40 (71.4%) patients were free of sludge and showed normal gallbladder findings. Gallbladder stones without sludge persistence developed in five patients (8.9%) within 2.5 +/- 0.6 mo after diagnosis of sludge, and gallstones with persistence of sludge developed in two other patients (3.6%) after 6.1 and 30.7 mo, respectively. In no cases did the stones become clinically symptomatic in the course of the follow-up period. Acute acalculous cholecystitis developed in four patients (7.1%) from 6.5 to 37.5 mo after the first examination. In five patients, sludge persisted after a mean 22.3 +/- 13.5 mo of follow-up. Although our data show that gallbladder sludge disappeared spontaneously within a relatively short time in 71.4% of patients, gallbladder sludge must be considered an important pathologic entity because gallbladder stones or complications such as acute cholecystitis occurred in 19.6% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…As such, OCG is required prior to admission for nonsurgical treatment of gallstones. During the past decade, several authors have claimed that US can replace OCG both for determining the number and size of gallstones [16,17] and for studying gallbladder contraction [7][8][9][10][11][12][13]. Indeed, since gallstones are diagnosed mostly with US, it seems desirable to obtain as much information as possible with this procedure in order to assess the eligibility of patients for nonsurgical treatment.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonic evaluation of gallbladder emptying with ceruletide: comparison to oral cholecystography with fatty meal

Muraca

¹

,

Cianci

²

,

Miconi

³

et al. 1994

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Assessment of gallbladder function is required prior to nonsurgical treatment of gallstones. In order to develop a practical and reproducible method of evaluation, gallbladder emptying was studied by ultrasound (US) in 55 gallstone patients after intramuscular administration of ceruletide (0.3 micrograms/kg). In 27 of these subjects, the US procedure was compared to oral cholecystography (OCG) with fatty meal. Maximal percent gallbladder contraction was reached 30 min after ceruletide in all patients. Maximal percent contractions were 47.5 +/- 27.7 during US with ceruletide and 33.9 +/- 16.3 during OCG with fatty meal (p = 0.03). A significant linear relationship was found between the results obtained with the two different procedures (r = 0.57; p = 0.002). Serial US determinations of gallbladder emptying were performed in 16 patients. Individual variation was below 20% in 11 subjects, and in five subjects it ranged between 20 and 40%. Minor, self-limiting side effects were observed in 13 patients. US determination of gallbladder emptying after ceruletide appears to be a practical and reliable method to assess gallbladder function.

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“…Because of all the advantages connected with the method and a sensitivity of more than 95%, together with an approximately 99% specificity, no other diagnostic method can at present compete with abdominal sonography with regard to the detection of gallbladder stones. Sonography's sensitivity is 15% to 20% better than that routinely reported for cholecystography, and patients are not exposed to either radiation or iodine (1)(2)(3)(4)(5)(6). The reliability in the gallstone diagnosis above all depends on the experience of the investigator.…”

Section: )mentioning

confidence: 99%

Gallbladder sludge: Spontaneous course and incidence of complications in patients without stones

Janowitz

¹

1994

View full text Add to dashboard Cite

Although the ultrasonic detection of gallbladder sludge is relatively frequent, its clinical importance remains unclear, partly because of the paucity of reliable investigations regarding its natural course in patients without stones. In a retrospective study we investigated the course and clinical significance of gallbladder sludge in patients without stones or other identified gallbladder abnormalities. The diagnosis of gallbladder sludge was made by ultrasound scan in 286 (1.7%) of 17,021 patients. The mean follow-up period for these patients was 20.3 +/- 11.5 mo. Of this group 56 patients were without both stones and sludge at the initial examination, and gallbladder sludge developed after a mean observation period of 11.2 +/- 10.6 mo. Within 2.0 +/- 3.5 mo after sludge detection, 40 (71.4%) patients were free of sludge and showed normal gallbladder findings. Gallbladder stones without sludge persistence developed in five patients (8.9%) within 2.5 +/- 0.6 mo after diagnosis of sludge, and gallstones with persistence of sludge developed in two other patients (3.6%) after 6.1 and 30.7 mo, respectively. In no cases did the stones become clinically symptomatic in the course of the follow-up period. Acute acalculous cholecystitis developed in four patients (7.1%) from 6.5 to 37.5 mo after the first examination. In five patients, sludge persisted after a mean 22.3 +/- 13.5 mo of follow-up. Although our data show that gallbladder sludge disappeared spontaneously within a relatively short time in 71.4% of patients, gallbladder sludge must be considered an important pathologic entity because gallbladder stones or complications such as acute cholecystitis occurred in 19.6% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

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Accuracy of ultrasound in counting and measuring gallstones

Cited by 6 publications

References 5 publications

Gallbladder sludge: Spontaneous course and incidence of complications in patients without stones

Gallbladder sludge: Spontaneous course and incidence of complications in patients without stones

Ultrasonic evaluation of gallbladder emptying with ceruletide: comparison to oral cholecystography with fatty meal

Gallbladder sludge: Spontaneous course and incidence of complications in patients without stones

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