Imaging techniques in acute cholecystitis].

UMCU, afd. Chirurgie, Utrecht, the Netherlands. h.vansantvoort@umcutrecht.nl

Nederlands tijdschrift voor geneeskunde 2013

A recent meta-analysis of 57 studies investigated the diagnostic accuracy of imaging techniques in acute cholecystitis. The main findings were that abdominal ultrasound has a sensitivity of 81% and a specificity of 83%, that ultrasound seems comparable to magnetic resonance imaging (MRI), that cholescintigraphy has a sensitivity of 96% and a specificity of 90%, and that there are insufficient studies to evaluate the role of computed tomography (CT). In daily practice, ultrasound is the preferred modality as it is safe, widely available and cheap. MRI and cholescintigraphy are less available and have additional disadvantages. Patients with a negative or inconclusive ultrasound examination should undergo CT as this is in line with the general diagnostic strategy for acute abdominal pain that results in the highest sensitivity for urgent conditions and lowest exposure to radiation. Patients with clinical suspicion of acute cholecystitis but negative imaging findings should undergo prompt diagnostic laparoscopy and potentially cholecystectomy.