How do ultrasound, HIDA scan and CT compare for diagnosing acute cholecystitis?

Bottom line:  HIDA scan has greater sensitivity and specificity than ultrasound and greater specificity than CT although data on CT scanning is scarce.

SummaryAcute Cholecystitis.  In:  DynaMed.
In the Diagnosis>Imaging Studies section, the following data is provided on diagnostic accuracy:
Kiewiet JJ, et al.  A systematic review and meta-analysis of diagnostic performance of imaging in acute cholecystitis.  Radiology. 2012 Sep;264(3):708-20. doi: 10.1148/radiol.12111561. Epub 2012 Jul 12. Systematic review of studies of varying quality.  Compared to reference standard of surgery and/or clinical follow-up:

  • Ultrasound (pooled from 26 studies, N=2847):  sensitivity 81% and specificity 83%
  • HIDA scan (pooled from 40 studies, N=4090): sensitivity 96% and specificity 90%
  • Direct comparison ultrasound v. HIDA scan (11 studies, N=1199):  sensitivity 80% for ultrasound v. 94% for HIDA scan; specificity 75% v. 89%
  • CT scan one study, N=49:  sensitivity 94% and specificity 59%

 

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About Amy

Clinical Informationist at EUH Branch Library
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