Objective To investigate the diagnostic value of CT scanning and MR imaging on acute cholecystitis.
Methods The CT or MR imaging data of 21 patients with proved acute cholecystitis were retrospectively reviewed. Eleven patients were examined with contrast-enhanced multi-detector-row spiral CT scanning and other 10 cases underwent contrast-enhanced MR imaging.
Results Nineteen patients showed obscure gallbladder outlines （90.5%）. The gallbladder wall demonstrated even thickening in 15 patients （71.4%） and irregular thickening in 6 cases （28.6%）. All patients showed inhomogeneous enhancement of the gallbladder wall （100%）. The bile was hyper-dense or hyper-intense on T1W image in 11 cases （52.4%）. Ten cases had free peri-cholecystic effusion （47.6%）, and 16 cases had peri-cholecystic adhesive changes or fat swelling （76.2%）. Patchy or linear-like transient enhancement of the adjacent hepatic bed in the arterial phase was seen in 16 cases （76.2%）. Twelve patients developed pleural effusion, or ascites, or both （57.1%）. Gallbladder perforation complicated with peritonitis was seen in one case, micro-abscess formation and pneumocholecystitis was observed in another case, and one case had gallbladder diverticulum.
Conclusion Wall blurring, pericholecystic adhesion or fat edema, and transient enhancement of adjacent hepatic bed in the arterial phase are the imaging findings specifically associated with acute cholecystitis, which are readily appreciated on contrast-enhanced multi-phasic CT and MR scanning.
Citation：
ZHAO Liming,SONG Bin,WU Bi,YANG Ningjing.. Diagnostic Value of CT and MRI on Acute Cholecystitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(9): 699-703. doi:
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Copyright © the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
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- 1. 张运波， 张静， 安伟， 等. 急性胆囊炎的临床、病理与影像学对照研究（附39例报告） [Ｊ] . 现代医用影像学， 2007； 16(4)∶171.
- 2. 吴恩惠， 白人驹， 刘望彭， 等主编. 医学影像诊断学 [M]. 第1版. 北京: 人民卫生出版社， 2001∶676.
- 3. 邬颖华， 宋彬， 罗小华， 等. 肝病性胆囊改变与胆囊炎性改变的多排螺旋CT鉴别诊断 [Ｊ]. 中国普外基础与临床杂志， 2005； 12(1)∶82.
- 4. Fidler J, Paulson EK, Layfield L. CT evaluation of acute cholecystitis: findings and usefulness in diagnosis [Ｊ]. AJR Am J Rotengenol, 1996; 166(5)∶1085.
- 5. 张兆林， 祁吉. 急性胆囊炎的CT评价 [Ｊ]. 国外医学·临床放射学分 分册， 1997； 6∶365.
- 6. 张健， 孟繁荣. 急性胆囊炎的分型及其影像解剖学研究 [Ｊ]. 解剖学研究， 2006； 28(3)∶218.
- 7. Jung SE， Lee JM， Lee K， et al. Gallbladder wall thickening： MR imaging and pathologic correlation with emphasis on layered pattern [Ｊ]. Eur Radiol, 2005; 15(4)∶694.
- 8. Bennett GL， Rusinek H， Lisi V， et al. CT findings in acute gangrenous cholecystitis [Ｊ]. AJR Am J Rotengenol, 2002; 178(2)∶275.
- 9. Yamashita K， Jin MJ， Hirose Y， et al. CT findings of transient focal increased attenuation of the liver adjacent to the gallbladder in acute cholecystitis [Ｊ]. AJR Am J Rotengenol, 1995; 164(2)∶343.
- 10. Choi SH， Lee JM， Lee KH， et al. Relationship between various patterns of transient increased hepatic attenuation on CT and portal vein thrombosis related to acute cholecystitis [Ｊ]. AJR Am J Rotengenol, 2004; 183(2)∶437.
- 11. Altun E, Semelka RC, Elias J Jr, et al. Acute cholecystitis：MR findings and differentiation from chronic cholecystitis [Ｊ]. Radiology, 2007; 244(1)∶174.
