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Contrast-enhanced ultrasonography with Sonazoid for diagnosis of gangrenous cholecystitis

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Abstract

Purpose

This prospective study investigated the ability of contrast-enhanced ultrasonography (CEUS) with Sonazoid to diagnose gangrenous cholecystitis and determined the inter-observer agreement.

Methods

From September 2012 to August 2014, 27 patients with acute cholecystitis underwent preoperative CEUS (registration number 1277). After Sonazoid injection, harmonic imaging of the gallbladder wall was performed, and the findings were recorded using movie clips. The signal intensity was classified as absence (uncomplicated) or presence of perfusion defects (gangrenous). The physician performing CEUS recorded the findings immediately after the examination. Another physician (blinded to the clinical information) then reviewed the movie clips and recorded the findings. The final diagnosis was determined by histological examination in all 27 patients.

Results

The final diagnosis was gangrenous cholecystitis in 15 patients and uncomplicated cholecystitis in 12. On CEUS examination, perfusion defects were detected in 10 patients with gangrenous cholecystitis, giving a sensitivity of 66.7 %, specificity of 100 %, positive predictive value of 100 %, and negative predictive value of 70.6 %. On review of the movie clips, these values were 73.3, 100, 100, and 75.0 %, respectively. The inter-observer agreement between physicians was good (κ coefficient, 0.64).

Conclusions

CEUS with Sonazoid is a useful and reproducible modality for diagnosing gangrenous cholecystitis.

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Authors and Affiliations

  1. Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School Hospital, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan

    Ryousuke Kawai, Jiro Hata, Noriaki Manabe, Hiroshi Imamura & Ai Iida

  2. Department of Gastroenterology, Kawasaki Medical School Hospital, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan

    Rui Nakatou

  3. Department of Hepatology and Pancreatology, Kawasaki Medical School Hospital, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan

    Nobuko Koyama

  4. Department of Digestive Surgery, Kawasaki Medical School Hospital, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan

    Toshihiro Hirai

  5. Department of Pathology, Kawasaki Medical School Hospital, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan

    Yoshito Sadahira

Authors
  1. Ryousuke Kawai
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  2. Jiro Hata
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  3. Noriaki Manabe
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  4. Hiroshi Imamura
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  5. Ai Iida
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  6. Rui Nakatou
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  7. Nobuko Koyama
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  8. Toshihiro Hirai
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  9. Yoshito Sadahira
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Corresponding author

Correspondence to Ryousuke Kawai.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.

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Kawai, R., Hata, J., Manabe, N. et al. Contrast-enhanced ultrasonography with Sonazoid for diagnosis of gangrenous cholecystitis. J Med Ultrasonics 43, 193–199 (2016). https://doi.org/10.1007/s10396-015-0677-6

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  • DOI: https://doi.org/10.1007/s10396-015-0677-6

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