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Impact of transient hepatic attenuation differences on computed tomography scans in the diagnosis of acute gangrenous cholecystitis
Author(s) -
Uemura Shuichiro,
Higuchi Ryota,
Yazawa Takehisa,
Izumo Wataru,
Sugishita Toshiya,
Morita Satoru,
Yamamoto Masakazu
Publication year - 2019
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.637
Subject(s) - medicine , computed tomography , cholecystitis , receiver operating characteristic , nuclear medicine , radiology , acute cholecystitis , gallbladder , surgery
Background We examined the utility of transient hepatic attenuation differences ( THAD s) detected in the arterial phase of computed tomography for the diagnosis of acute gangrenous cholecystitis (AGC). Methods We examined 83 consecutive patients who underwent cholecystectomy within 72 h of undergoing three‐phase dynamic computed tomography scans for acute cholecystitis between 2009 and 2018 (histopathological examination later confirmed 42 with AGC, 41 without). The THAD volume (cm 3 ) was calculated by multiplying the total area of the enhancing lesions (traced on axial images) by the thickness of the scan (0.5‐cm slices). We evaluated the sensitivity and specificity of the THAD volume and other computed tomography findings of AGC. Results The THAD volume was significantly larger in the AGC group than in the non‐gangrenous acute cholecystitis group ( P < 0.0001). The cutoff value of 78 cm 3 , determined using a receiver operating characteristics curve, yielded a sensitivity of 88.1% and specificity of 75.6% for detecting AGC. Multivariate analysis revealed a THAD volume of >78 cm 3 to be an independent predictor of AGC. Conclusions Acute gangrenous cholecystitis can be diagnosed using THAD volume, resulting in improved treatment and fewer serious complications.