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      급성 괴저성 담낭염의 CT 소견

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      https://www.riss.kr/link?id=A60301910

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      다국어 초록 (Multilingual Abstract)

      Purpose: Acute gangrenous cholecystitis (AGC) is a severe advanced form of cholecystitis, and it has a higher morbidity and mortality rate than that of acute nongangrenous cholecystitis (ANGC). Identifying the CT findings of gangrenous cholecystitis w...

      Purpose: Acute gangrenous cholecystitis (AGC) is a severe advanced form of cholecystitis, and it has a higher morbidity and mortality rate than that of acute nongangrenous cholecystitis (ANGC). Identifying the CT findings of gangrenous cholecystitis will enable physicians to make an early diagnosis and administer aggressive treatment.
      Methods: From January 2005 to October 2007, the CT scans in 277 patients (80 with AGC, 149 with ANGC and 45 with normal gallbladder (NGB)) were retrospectively reviewed by 2 radiologists. We evaluated the findings that included wall thickening (>3mm), distension (transverse diameter > 5cm), gallstones, pericholecystic fluid, pericholecystic inflammation, mural striation, adjacent hepatic enhancement, pericholecystic abscess, an intraluminal membrane, an irregular or absent wall, gas in the wall or lumen, and intraperitoneal fluid. The sensitivity and specificity of the each CT finding for diagnosing AGC were calculated. The dimension and wall thickness of the gallbladder were also measured.
      Results: The sensitivity, specificity and accuracy of CT for diagnosing AGC were 27%, 94% and 74%, respectively. The findings with the highest specificity for AGC were gas in the wall or lumen (100%), intraluminal membranes (99.5%), pericholecystic abscess (99.5%), an irregular or absent wall (98.5%), adjacent hepatic enhancement (97.9%), intraperitoneal fluid (96.9%), pericholecystitic fluid (95.6%), and mural striation (93.8%). The difference of the mean gallbladder wall thickness between the groups was statistically significant.
      Conclusion: These specific CT findings, including the GB wall thickness, will assist clinicians in making an earlier and more exact diagnosis of gangrenous cholecystitis

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      목차 (Table of Contents)

      • 서론
      • 방법
      • 결과
      • 고찰
      • 결론
      • 서론
      • 방법
      • 결과
      • 고찰
      • 결론
      • 참고문헌
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      참고문헌 (Reference)

      1 Kane RA, "computed tomography in acute cholecystitis: new observations" 141 : 697-701, 1983

      2 Nguyen Liz, "Use of a predictive equation for diagnosis of acute gangrenous cholecystitis" 188 : 463-466, 2004

      3 Simone J, "The sonographic diagnosis of acute gangrenous cholecystitis: Importance of the Murphy sign" 152 : 289-290, 1989

      4 Sariego J, "Significance of wall thickness in symptomatic gall bladder disease" 127 : 1216-1218, 1992

      5 Habib FA, "Role of laparoscopic cholecystectomy in the management of gangrenous cholecystitis in acute cholecystitis" 181 : 71-75, 2001

      6 Robbins SL, "Pathology" WB Saunders 1967

      7 Mok P, "Loss of the mucosal lining/gallbladder wall echo:A sonographic sign of gangrenous cholecystitis" 38 : 294-297, 1994

      8 Kim Ho, "Laparoscopic cholecystectomy in the elderly patients" 64 : 160-164, 2003

      9 Decker G, "Laparoscopic cholecystectomy for acute cholecystitis in geriatric patients" 101 : 294-299, 2001

      10 Eldar S, "Laparoscopic chlecystectomy for acute cholecystitis: prospective trial" 21 : 540-545, 1997

      1 Kane RA, "computed tomography in acute cholecystitis: new observations" 141 : 697-701, 1983

      2 Nguyen Liz, "Use of a predictive equation for diagnosis of acute gangrenous cholecystitis" 188 : 463-466, 2004

      3 Simone J, "The sonographic diagnosis of acute gangrenous cholecystitis: Importance of the Murphy sign" 152 : 289-290, 1989

      4 Sariego J, "Significance of wall thickness in symptomatic gall bladder disease" 127 : 1216-1218, 1992

      5 Habib FA, "Role of laparoscopic cholecystectomy in the management of gangrenous cholecystitis in acute cholecystitis" 181 : 71-75, 2001

      6 Robbins SL, "Pathology" WB Saunders 1967

      7 Mok P, "Loss of the mucosal lining/gallbladder wall echo:A sonographic sign of gangrenous cholecystitis" 38 : 294-297, 1994

      8 Kim Ho, "Laparoscopic cholecystectomy in the elderly patients" 64 : 160-164, 2003

      9 Decker G, "Laparoscopic cholecystectomy for acute cholecystitis in geriatric patients" 101 : 294-299, 2001

      10 Eldar S, "Laparoscopic chlecystectomy for acute cholecystitis: prospective trial" 21 : 540-545, 1997

      11 McDonnell CH III, "Inflamed pericholecystic fat: color Doppler flow imaging and clinical feature" 193 : 547-550, 1994

      12 Park YH, "Hepato-biliary-pancreatic surgery" Euihak Moonwhasa 2006

      13 Hunt DRH, "Gangrenous cholecystits in the laparoscopic era" 70 : 428-430, 2000

      14 Merriam LT, "Gangrenous cholecystitis; analysis of risk factors and experience with laparoscopic cholecystectomy" 126 : 680-686, 1999

      15 Teefey SA, "Gangrenous cholecystitis: new observations on sonography" 10 : 603-606, 1991

      16 Morfin E, "Gangrenous cholecystitis" 96 : 567-572, 1968

      17 Fry DE, "Gangrene of the gallbladder; a complication of acute cholecystitis" 74 : 666-668, 1981

      18 Ito K, "Gallbladder disease: appearance of associated transient increased attenuation in the liver at biphasic, contrastenhanced dynamic CT" 204 : 723-728, 1997

      19 Berirli A, "Factors effecting the complication the natural history of acute cholecystitis" 48 : 1275-1278, 2001

      20 Chiu HH, "Emphysematous cholecystitis" 188 : 325-326, 2004

      21 Bingener J, "Early conversion for gangrenous cholecystitis: impact on outcome" 19 : 1139-1141, 2005

      22 Weiss CA, "Current diagnosis and treatment of cholecystitis" 59 : 51-54, 2002

      23 Varma DGK, "Computed tomography of gangrenous acute postoperative acalculous cholecystitis" 12 : 29-31, 1988

      24 Lamki N, "Computed tomography of complicated cholecystitis" 10 : 319-324, 1986

      25 Bennet GL, "CT findings in acute gangrenous cholecystis" 178 : 275-281, 2002

      26 Fidler J, "CT evaluation of Acute Cholecystitis: Findings and Usefullness in Diagnosis" 166 : 1085-1088, 1996

      27 Mirvis SE, "CT diagnosis of acalculous cholecystitis" 11 : 83-87, 1987

      28 Paulson EK, "Acute cholecystitis: CT findings" 21 : 56-63, 2000

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