UEMURA Shuichiro
Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Assistant Professor |
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Article types | Original article |
Language | English |
Peer review | Peer reviewed |
Title | Impact of transient hepatic attenuation differences on computed tomography scans in the diagnosis of acute gangrenous cholecystitis. |
Journal | Formal name:Journal of hepato-biliary-pancreatic sciences Abbreviation:J Hepatobiliary Pancreat Sci ISSN code:18686982/18686974 |
Volume, Issue, Page | 26(8),pp.348-353 |
Author and coauthor | Uemura Shuichiro, Higuchi Ryota, Yazawa Takehisa, Izumo Wataru, Sugishita Toshiya, Morita Satoru, Yamamoto Masakazu |
Authorship | Lead author |
Publication date | 2019/08 |
Summary | 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 |