Shapira-Rootman Mika, Mahamid Ahmad, Reindorp Nadir, Nachtigal Alicia, Zeina Abdel-Rauf
Department of Radiology (M.S.-R., N.R., A.N., A.-R.Z.) and Division of Surgery (A.M.), Hillel Yaffe Medical Center, Hadera, Israel; affiliated with the Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
J Ultrasound Med. 2015 Dec;34(12):2231-6. doi: 10.7863/ultra.14.12072. Epub 2015 Oct 30.
Early detection of the complications of cholecystitis is important for clinical management, yet only a small percentage of patients have a correct diagnosis before surgery. The purpose of our study was to identify sonographic findings that are associated with complicated cholecystitis.
Sonographic, surgical, and pathologic reports were reviewed for 70 patients who underwent early cholecystectomies from January 2010 to August 2014. Sonograms were assessed for 16 independent variables. Statistical analyses were performed to evaluate associations between various sonographic features and complicated cholecystitis.
Sonographic signs associated with complicated cholecystitis (P< .05) were a greater short-axis gallbladder diameter (mean, 4.4 versus 4.0 cm), a greater mean wall thickness (5.6 versus 4.2 mm), and the likelihood of wall striations, gallbladder echogenic content, pericholecystic free fluid, and local inflammatory fat changes. Specific sonographic signs, such as sloughed intraluminal membranes, were detected in a small percentage of cases (10%). None of the sonographic features evaluated in this study was found to be sensitive and specific enough to indicate complicated cholecystitis. In most cases, sonograms reflected severe inflammation, with multiple sonographic signs.
Although multiple sonographic signs are associated with complicated cholecystitis, none of them is sensitive and specific enough to definitively diagnose it. Sonograms usually reflect severe inflammation, with numerous sonographic signs. Thus, in the right clinical context, sonograms of severe cholecystitis should alert radiologists to the possibility of complications.
早期发现胆囊炎并发症对临床治疗很重要，但只有一小部分患者在手术前能得到正确诊断。我们研究的目的是确定与复杂性胆囊炎相关的超声检查结果。
回顾了2010年1月至2014年8月期间接受早期胆囊切除术的70例患者的超声、手术和病理报告。对超声图像评估了16个独立变量。进行统计分析以评估各种超声特征与复杂性胆囊炎之间的关联。
与复杂性胆囊炎相关的超声征象（P<0.05）包括胆囊短轴直径更大（平均4.4对4.0 cm）、平均壁厚度更大（5.6对4.2 mm）以及出现壁条纹、胆囊内回声物质、胆囊周围游离液和局部炎性脂肪改变的可能性。在一小部分病例（10%）中检测到了特定的超声征象，如腔内脱落的膜。本研究评估的超声特征均未发现对复杂性胆囊炎有足够的敏感性和特异性。在大多数情况下，超声图像反映了严重炎症，有多种超声征象。
虽然多种超声征象与复杂性胆囊炎相关，但它们均不足以敏感且特异地确诊该病。超声图像通常反映严重炎症，有众多超声征象。因此，在合适的临床背景下，严重胆囊炎的超声图像应提醒放射科医生注意并发症的可能性。
