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Added value of 2D shear wave imaging of the gallbladder bed of the liver for acute cholecystitis

Ultrasonography 2020년 39권 4호 p.384 ~ 393
고아라, 이은선, 박현정, 박성빈, 김희성, 최병인,
소속 상세정보
고아라 ( Ko A-Ra ) - Chung-Ang University College of Medicine Chung-Ang University Hospital Department of Radiology
이은선 ( Lee Eun-Sun ) - Chung-Ang University College of Medicine Chung-Ang University Hospital Department of Radiology
박현정 ( Park Hyun-Jeong ) - Chung-Ang University College of Medicine Chung-Ang University Hospital Department of Radiology
박성빈 ( Park Sung-Bin ) - Chung-Ang University College of Medicine Chung-Ang University Hospital Department of Radiology
김희성 ( Kim Hee-Sung ) - Chung-Ang University College of Medicine Chung-Ang University Hospital Department of Pathology
최병인 ( Choi Byung-Ihn ) - Chung-Ang University College of Medicine Chung-Ang University Hospital Department of Radiology

Abstract


Purpose: The purpose of this study was to evaluate whether shear wave elastography (SWE) and the shear wave dispersion slope (SWD) obtained from 2-dimensional shear wave imaging (2D-SWI) of the gallbladder (GB) bed of the liver could be helpful in the diagnosis of acute cholecystitis.

Methods: We included 44 patients referred for abdominal ultrasonography (US) under the impression of acute cholecystitis from April 2018 to March 2019. Patients with chronic liver disease were excluded from this study. In addition to routine upper abdominal US, we performed 2D-SWI including liver stiffness measurements by SWE and SWD, which reflects tissue viscosity. 2D-SWI was performed at the GB bed of the liver through the right intercostal approach at least 3 times with different frames. We assessed typical US findings and the added value of 2D-SWI in diagnosing acute cholecystitis. Histopathologic results of surgical specimens were used as the standard of reference. If a surgical specimen was unavailable, a bile fluid test or clinical follow-up for more than 3 months served as the reference standard.

Results: The optimal cutoff values for SWE and SWD were 8 kPa and 10.9 (m/sec)/kHz, respectively. In the univariate analysis, SWE, GB distension, and sludge were predictive factors of acute cholecystitis. In the multivariate analysis, categorized SWE was the only significant predictor (P<0.01). By using 2D-SWI, the diagnostic performance of two readers did not significantly increase, although the inter-reader agreement improved (k=0.654-0.778).

Conclusion: 2D-SWI of the GB bed of the liver could be helpful for diagnosing acute cholecystitis.

키워드

Gallbladder; Acute cholecystitis; Ultrasonography; Diagnostic imaging; Elasticity imaging techniques

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