Runde Rachel, Auyang Edward D, Ng Raye, Llorente Kaysey, Tiwari Hina Arif, Elman Shana, Thompson William M
Department of Radiology, University of New Mexico, MSC10 5530, 1 University of New Mexico, Albuquerque, NM, 87131, USA.
Department of Surgery, University of New Mexico, Albuquerque, NM, USA.
Abdom Radiol (NY). 2023 Jan;48(1):2-28. doi: 10.1007/s00261-022-03429-0. Epub 2022 Mar 29.
This review focuses mainly on the imaging diagnosis, treatment, and complications of acute cholecystitis which is the most common benign disease of the gallbladder. The American College of Radiology appropriateness criteria for the imaging evaluation of patients with right upper quadrant pain and the Tokyo Guidelines for evaluating patients with acute cholecystitis and acute cholangitis are presented. The recent articles for using US, CT, MR, and HIDA in the evaluation of patients with suspected acute cholecystitis are reviewed in detail. The clinical management and postoperative complications are described. Because gallbladder polyps and adenomyomatosis can mimic gallbladder malignancies and acute cholecystitis, their imaging findings and management are presented. Finally, due the recent literature reporting better results with CT than US in the diagnosis of acute cholecystitis, a suggested approach for imaging patients with right upper quadrant pain and possible acute cholecystitis is presented in an addendum.
本综述主要聚焦于急性胆囊炎的影像诊断、治疗及并发症,急性胆囊炎是胆囊最常见的良性疾病。文中介绍了美国放射学会针对右上腹疼痛患者影像评估的适宜性标准以及东京急性胆囊炎和急性胆管炎患者评估指南。详细回顾了近期关于使用超声(US)、计算机断层扫描(CT)、磁共振成像(MR)和肝胆动态显像(HIDA)评估疑似急性胆囊炎患者的文章。描述了临床管理及术后并发症。由于胆囊息肉和腺肌症可类似胆囊恶性肿瘤及急性胆囊炎,故也介绍了它们的影像表现及处理方法。最后,鉴于近期文献报道CT在急性胆囊炎诊断中比US效果更佳,附录中给出了针对右上腹疼痛且可能患有急性胆囊炎患者的影像检查建议方法。