MR imaging in clinically suspected acute cholecystitis: A comparison with ultrasonography

Hakansson, K; Leander, Peter; Ekberg, Olle; Håkansson, Hans-Olof

doi:10.1080/028418500127345587

Cited by 61 publications

(26 citation statements)

References 16 publications

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“…Both conventional magnetic resonance imaging (MRI) [22-24] and magnetic resonance cholangiopancreatography [23,24] have been evaluated in the diagnosis of acute calculous cholecystitis and its complications [25]. When compared to ultrasonography, some have found MRI to be equivalent [26] and some have found it to be superior [27].…”

Section: Resultsmentioning

confidence: 99%

“…Acute cholecystitis accounts for 3–10% of all patients with abdominal pain and is the most common cause of acute abdominal pain in the right upper quadrant, especially in the elderly patients [25]. Sonography is still used as the initial imaging technique for evaluating patients with suspected gallbladder (GB) disease because of its high sensitivity at the detection of GB stones, its real-time character, and its speed and portability [26].…”

Section: Discussionmentioning

confidence: 99%

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Accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis: review of the literature

et al. 2013

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BackgroundTo evaluate the accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis in comparison with other imaging modalities.MethodsThe authors performed a search of the Medline/ PubMed (National Library of Medicine, Bethesda, Maryland) for original research and review publications examining the accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis. The search design utilized a single or combination of the following terms : (1) acute cholecystitis, (2) ultrasonography, (3) computed tomography, (4) magnetic resonance cholangiopancreatography and (5) cholescintigraphy. This review was restricted to human studies and to English-language literature. Four authors reviewed all the titles and subsequent the abstract of 198 articles that appeared appropriate. Other articles were recognized by reviewing the reference lists of significant papers. Finally, the full text of 31 papers was reviewed.ResultsSonography is still used as the initial imaging technique for evaluating patients with suspected acute calculous cholecystitis because of its high sensitivity at the detection of GB stones, its real-time character, and its speed and portability. Cholescintigraphy still has the highest sensitivity and specificity in patients who are suspected of having acute cholecystitis. However, due to a combination of reasons including logistic drawbacks, broad imaging capability and clinician referral pattern the use of cholescintigraphy is limited in clinical practice. CT is particularly useful for evaluating the many complications of acute calculous cholecystitis. The lack of widespread availability of MRI and the relatively high cost prohibits its primary use in patients with acute calculous cholecystitis.ConclusionsUS is currently considered the preferred initial imaging technique for patients who are clinically suspected of having acute calculous cholecystitis.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis: review of the literature

et al. 2013

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“…In the current study, the sensitivity of DWIBS/ T2 in the diagnosis of acute cholecystitis was 90.9%. Similarly, previous results have indicated that DWIBS/T2 is superior to US and CT as a diagnostic tool (27,28), possibly due to the distinct contrast between high signal intensity regions and surrounding tissues detected by DWIBS/T2, which makes diagnosis more accurate. Indeed, contrast agents are considered to be useful in the diagnosis of biliary diseases (29).…”

Section: Discussionmentioning

confidence: 94%

Diffusion-weighted whole-body magnetic resonance imaging with background body signal suppression/T2 image fusion for the diagnosis of acute cholecystitis

Tomizawa

Shinozaki

Tanaka

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. Prompt and accurate diagnosis is critical in the treatment of acute cholecystitis. Diffusion-weighted whole-body magnetic resonance imaging with background body signal suppression/T2 image fusion (DWIBS/T2) identifies areas with high signal intensity, corresponding to inflammation. In the present study, the records and images of patients with acute cholecystitis who underwent DWIBS/T2 between January 2013 and March 2014 were retrospectively analyzed. A total of 11 patients with acute cholecystitis were enrolled. In one patient, DWIBS/T2 identified a thickened wall and high signal intensity, with high signal intensity in the pericholecystic space that suggested localized peritonitis. Positive DWIBS/T2 results indicating acute cholecystitis were obtained in 10/11 patients, with a sensitivity of 90.9%. In addition, wall thickening and high signal intensity were absent in DWIBS/T2 images when wall thickening was not detected by computed tomography. Wall thickening and high signal intensity was attenuated when patients with acute cholecystitis were clinically treated. These data suggest that a thickened gallbladder wall and high signal intensity are indicative of acute cholecystitis and that DWIBS/T2 may be a useful technique in evaluating the severity of acute cholecystitis. IntroductionAcute cholecystitis is characterized by inflammation of the gallbladder and typically occurs due to obstruction of the gallbladder neck or cystic duct by a gallstone (1). Gallbladder infection may also spread to the liver or pericholecystic cavity and lead to the development of liver abscesses or peritonitis, respectively (2-4). Therefore, prompt treatment with cholecystectomy, percutaneous transhepatic gallbladder drainage or aspiration is typically recommended following diagnosis of acute cholecystitis (5-7). Accurate diagnosis is also critical for the appropriate management of acute cholecystitis (8).Diffusion-weighted whole-body magnetic resonance imaging with background body signal suppression (DWIBS) is based on a diffusion-weighted imaging (DWI) technique, which enables visualization of the random movement of water molecules (Brownian motion) for diagnostic imaging (9). Images are acquired with DWIBS during free breathing of the patient through the use of multiple-signal averaging, fat suppression and heavy diffusion weighting (10). In particular, a high signal intensity of DWIBS is a positive indicator of cancer and inflammation. An advantage of DWIBS over DWI is that it exhibits positive signals with strong contrast against surrounding normal tissues. However, the evaluation of positive signals to obtain anatomical information becomes difficult when signals in the surrounding tissues are suppressed (11,12). Images obtained from DWIBS are fused with their corresponding T2-weighted images using a workstation (13-15). DWIBS and T2-weighted image fusion (DWIBS/T2) enables anatomical evaluation of the positive signals obtained from DWIBS (16). Therefore, the present study retrospectively analyzed images obtained by DWIB...

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“…Modern MR systems with fast pulse sequences acquired during breath‐hold give excellent images for visualisation of the biliary tree and liver parenchyma. Especially, T2W HASTE sequences without and with fat saturation have shown a high sensitivity to demonstrate oedema and fluid which is of great value in diagnosing inflammatory conditions (4, 7, 9, 10). These pulse sequences also give excellent image quality in uncooperative patients.…”

Section: Discussionmentioning

confidence: 99%

MR characteristics of acute cholangitis

Hakansson¹,

Ekberg²,

Håkansson³

et al. 2002

Acta Radiologica

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MR imaging in clinically suspected acute cholecystitis: A comparison with ultrasonography

Abstract: MR has a higher sensitivity than US for diagnosing acute cholecystitis and, with increased accessibility, may be the first imaging method.

Cited by 61 publications

References 16 publications

Accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis: review of the literature

Accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis: review of the literature

Diffusion-weighted whole-body magnetic resonance imaging with background body signal suppression/T2 image fusion for the diagnosis of acute cholecystitis

MR characteristics of acute cholangitis

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