Department of Surgery/VA Connecticut Healthcare System, Yale University School of Medicine, New Haven, CT, USA.
Am J Surg. 2011 Nov;202(5):524-7. doi: 10.1016/j.amjsurg.2011.06.012. Epub 2011 Sep 9.
Elderly patients diagnosed with acute cholecystitis (AC) may undergo both ultrasonography (US) and computed tomography (CT).
A total of 475 patients (age, >64 y) with AC were included.
Groups included US alone (n = 240), CT alone (n = 60), and CT + US (n = 168). Sixty patients (35.7%) in the US + CT group had inflammation in both studies, 34 (20.2%) had inflammation only on US, and 32 (19.0%) had inflammation only on CT. In the US + CT group, detection of cholelithiasis was not different, but mean common bile duct size did not correlate. There was no difference among the groups in age, sex, medical service admission, nonambulatory status, dementia, diabetes, or coronary artery disease. Peritonitis, leukocytosis, and acidosis were more frequent in the 2 groups undergoing CT. The cholecystectomy rate was lowest (and the complication rate was highest) in the CT + US group.
CT often is used in the diagnosis of AC in the elderly, especially those with more acute presentations. CT and US findings may be complementary in AC.
诊断为急性胆囊炎（AC）的老年患者可能同时接受超声（US）和计算机断层扫描（CT）检查。
共纳入 475 例 AC 老年患者（年龄>64 岁）。
US 组（n=240）、CT 组（n=60）和 CT+US 组（n=168）。US+CT 组中 60 例（35.7%）患者两项检查均有炎症，34 例（20.2%）US 检查有炎症，32 例（19.0%）CT 检查有炎症。US+CT 组中，胆囊结石的检出率无差异，但胆总管平均直径与 CT 结果不相关。US+CT 组与 CT 组在年龄、性别、医疗服务入院、非活动性状态、痴呆、糖尿病或冠状动脉疾病方面无差异。在接受 CT 检查的 2 组中，腹膜炎、白细胞增多和酸中毒更为常见。US+CT 组的胆囊切除术率最低（并发症发生率最高）。
CT 常用于老年 AC 的诊断，尤其是病情更为急性的患者。AC 患者 CT 和 US 检查结果可能具有互补性。
