What is the role of imaging studies in the diagnosis of biliary colic and acute cholecystitis?

Updated: Jan 18, 2017
  • Author: Peter A D Steel, MBBS, MA; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Answer

Ultrasonography and nuclear medicine studies are the best imaging studies for the diagnosis of both cholecystitis and cholelithiasis. Ultrasonography is usually favored as the initial test, whereas hepatobiliary scintigraphy is usually reserved for the 20% of patients in whom the diagnosis is unclear after ultrasonography has been performed.

Plain radiography, computed tomography (CT) scans, and endoscopic retrograde cholangiopancreatography (ERCP) are diagnostic adjuncts. [13] Diffusion-weighted (DW) magnetic resonance imaging (MRI) shows potential for differentiating between acute and chronic cholecystits. [14] In a study comprising 83 patients with abdominal pain, Wang et al noted that increased signal on high b-value images were highly sensitive and moderately specific for acute cholecystitis. [14]


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