What is the role of contrast-enhanced ultrasonography (CEUS) in the diagnosis of cholecystitis?

Updated: May 20, 2021
  • Author: Alan A Bloom, MD; Chief Editor: BS Anand, MD  more...
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Contrast-enhanced ultrasonography (CEUS) with the agent perflubutane (Sonazoid) shows promise for its use in the diagnosis of gangrenous cholecystitis. [29] In a study comprising 27 patients with acute cholecystitis who underwent preoperative CEUS, 15 patients had a final diagnosis of gangrenous cholecystitis and 12 patients had uncomplicated cholecystitis, all confirmed via histologic examination. Of the 15 patients diagnosed with gangrenous cholecystitis, CEUS detected perfusion defects in 10 patients (66.7% sensitivity, 100% specificity; 100% positive predictive value [PPV] and 70.6% negative predictive value [NPV]). Review of the movie clips of the CEUS raised the sensitivity to 73.3% and the NPV to 75%. [29] Interobserver agreement was good (κ coefficient = 0.64).

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