Beyazal Mehmet, Avcu Serhat, Celiker Fatma Beyazal, Yavuz Alpaslan, Toktaş Osman
Department of Radiology, School of Medicine, Yüzüncü Yıl University, Van, Turkey,
Jpn J Radiol. 2014 Sep;32(9):545-51. doi: 10.1007/s11604-014-0343-8. Epub 2014 Jun 28.
The aim of the current study was to assess the efficiency of the apparent diffusion coefficient (ADC) measurement in diagnosis of acute cholecystitis and in differentiation of cholecystitis from extrinsic benign gallbladder wall thickening.
Forty patients who were diagnosed to have acute cholecystitis by ultrasonographic examination were included in this study. The control group consisted of 18 patients without symptoms of gallstones and cholecystitis whose gallbladder walls were thickened due to cirrhotic ascites. Both groups were examined using diffusion weighted imaging, and the mean ADC values were compared using Student's t-test.
The diagnoses of the 40 patients were proven by histopathological examination. The mean ADC values of patients diagnosed with cholecystitis (1.68 ± 0.36 × 10(-3) mm(2)/s) were significantly lower than the mean ADC values of the control group (2.35 ± 0.24 × 10(-3) mm(2)/s) (p < 0.05). Receiver operating characteristics curve analysis based on ADC revealed a cut-off value of 2.04 × 10(-3) mm(2)/s for the diagnosis of cholecystitis, with a sensitivity of 94% and a specificity of 89.7%.
ADC value quantification may be an efficient method for making a diagnosis of cholecystitis and in differential diagnosis of cholecystitis from the extrinsic benign gallbladder wall thickening that can be seen during the course of cirrhotic ascites.
本研究旨在评估表观扩散系数（ADC）测量在急性胆囊炎诊断以及胆囊炎与外在良性胆囊壁增厚鉴别诊断中的效率。
本研究纳入了40例经超声检查诊断为急性胆囊炎的患者。对照组由18例无胆结石和胆囊炎症状、因肝硬化腹水导致胆囊壁增厚的患者组成。两组均采用扩散加权成像进行检查，并使用学生t检验比较平均ADC值。
40例患者的诊断经组织病理学检查证实。诊断为胆囊炎的患者的平均ADC值（1.68±0.36×10⁻³mm²/s）显著低于对照组的平均ADC值（2.35±0.24×10⁻³mm²/s）（p<0.05）。基于ADC的受试者工作特征曲线分析显示，诊断胆囊炎的截断值为2.04×10⁻³mm²/s，灵敏度为94%，特异度为89.7%。
ADC值定量可能是诊断胆囊炎以及鉴别胆囊炎与肝硬化腹水过程中可见的外在良性胆囊壁增厚的有效方法。
