MR IMAGING IN CLINICALLY SUSPECTED ACUTE CHOLECYSTITIS. A comparison with ultrasonography

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

doi:10.1034/j.1600-0455.2000.041004322.x

Cited by 24 publications

(9 citation statements)

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“…Although MR findings of acute cholecystitis, chronic cholecystitis and gallbladder carcinoma have been reported [5,6,[13][14][15][16][17], to our knowledge, MR imaging findings in large series of patients with gallbladder disease and the schematic analysis of MR imaging findings for gallbladder wall thickening have not been well documented. Therefore, the purpose of this study was to correlate the MR findings of gallbladder wall thickening with the pathologic findings on the basis of the layered pattern and to evaluate the diagnostic value of HASTE MR imaging in gallbladder disease.…”

Section: Figmentioning

confidence: 94%

Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern

Jung

Lee

et al. 2004

Eur Radiol

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The aim of this study was to correlate MR findings of gallbladder wall thickening with pathologic findings on the basis of the layered pattern and to evaluate the diagnostic value of MR imaging in gallbladder disease. We retrospectively evaluated the source images of HASTE sequences for MR cholangiography in 144 patients with gallbladder wall thickening. The layered pattern of thickened wall was classified into four patterns. Type 1 shows two layers with a thin hypointense inner layer and thick hyperintense outer layer. Type 2 has two layers of ill-defined margin. Type 3 shows multiple hyperintense cystic spaces in the wall. Type 4 shows diffuse nodular thickening without layering. MR findings of a layered pattern of thickened gallbladder were well correlated with histopathology. Chronic cholecystitis matched to type 1, acute cholecystitis corresponded to type 2, adenomyomatosis showed type 3, and the gallbladder carcinomas showed type 4. All four layered patterns were associated with PPV of 73% or greater, sensitivity of 92% or greater and specificity of 95% or greater. Our results indicate that MR findings of gallbladder wall thickening are characteristic in each entity and correlate well with pathologic findings. The classification of the layered pattern may be valuable for interpreting thickened gallbladder wall.

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Section: Figmentioning

confidence: 94%

Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern

Jung

Lee

et al. 2004

Eur Radiol

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“…As with CT, MRI is not advocated as a primary imaging examination to evaluate acute right upper quadrant pain; however, several studies have suggested that abdominal MRI is a reliable alternative and can be particularly helpful in patients who are difficult to examine with ultrasound [21–23]. Although factors such as longer acquisition times limit its use in the emergency setting, less interpreter variability and more consistent visualization of the extrahepatic biliary tree are important advantages of its use [24, 25]. MRI can be the next best imaging modality when AC is excluded, and it is considered the best modality for evaluating hepatic and biliary abnormalities that are not characterized by ultrasound.…”

Section: Summary Of Literature Reviewmentioning

confidence: 99%

ACR Appropriateness Criteria Right Upper Quadrant Pain

Yarmish

Smith

Rosen

et al. 2014

Journal of the American College of Radiology

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Acute right upper quadrant pain is a common presenting symptom in patients with acute cholecystitis. When acute cholecystitis is suspected in patients with right upper quadrant pain, in most clinical scenarios, the initial imaging modality of choice is ultrasound. Although cholescintigraphy has been shown to have slightly higher sensitivity and specificity for diagnosis, ultrasound is preferred as the initial study for a variety of reasons, including greater availability, shorter examination time, lack of ionizing radiation, morphologic evaluation, confirmation of the presence or absence of gallstones, evaluation of bile ducts, and identification or exclusion of alternative diagnoses. CT or MRI may be helpful in equivocal cases and may identify complications of acute cholecystitis. When ultrasound findings are inconclusive, MRI is the preferred imaging test in pregnant patients who present with right upper quadrant pain. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

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“…In particular, T2W sequences with and without fat saturation have shown superior image quality also in patients who were not cooperative. Furthermore, the T2W HASTE sequences have a high sensitivity to oedema and fluid collections, which sensitivity is of great value in diagnosing inflammatory conditions and post‐operative surgical complications (4, 10, 11, 17, 21, 23).…”

Section: Discussionmentioning

confidence: 99%

MR and ultrasound in screening of patients with suspected biliary tract disease

Hakansson¹,

Ekberg²,

Håkansson³

et al. 2002

Acta Radiologica

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MR had a higher sensitivity than US for diagnosing biliary tract disease and MR was superior to US in visualising stones in the common bile duct and in diagnosing the cause of cholestasis. However, screening with US and supplemental MR in non-diagnostic cases is at present most cost-effective. With increased accessibility and slightly lower costs, MR will probably replace US as screening method in patients with suspected biliary tract disease.

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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 24 publications

References 0 publications

Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern

Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern

ACR Appropriateness Criteria Right Upper Quadrant Pain

MR and ultrasound in screening of patients with suspected biliary tract disease

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