スギシタ　トシヤ   Sugishita Toshiya   杉下　敏哉    所属   医学部 医学科（附属八千代医療センター）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Impact of transient hepatic attenuation differences on computed tomography scans in the diagnosis of acute gangrenous cholecystitis.
掲載誌名	正式名：Journal of hepato-biliary-pancreatic sciences 略　 称：J Hepatobiliary Pancreat Sci ISSNコード：18686982/18686974
巻・号・頁	26(8),pp.348-353
著者・共著者	Uemura Shuichiro, Higuchi Ryota, Yazawa Takehisa, Izumo Wataru, Sugishita Toshiya, Morita Satoru, Yamamoto Masakazu
発行年月	2019/08
概要	BACKGROUND:We examined the utility of transient hepatic attenuation differences (THADs) 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 (cm3 ) 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 cm3 , 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 cm3 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.
DOI	10.1002/jhbp.637
PMID	31125498