Value of nonenhanced CT combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis treated with percutaneous cholecystostomy: a retrospective study
Abstract Purposes In this study, we aimed to identify the distribution of presenting laboratory and nonenhanced computed tomography (CT) imaging features within 48 h before percutaneous cholecystostomy (PC) and create a model to appropriately guide the diagnosis of acute suppurative cholecystitis (A...
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-022-02224-x |
| _version_ | 1819025830051840000 |
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| author | Bai-Qing Chen Feng Xie Guo-Dong Chen Xue Li Xue Mao Bao Jia |
| author_facet | Bai-Qing Chen Feng Xie Guo-Dong Chen Xue Li Xue Mao Bao Jia |
| author_sort | Bai-Qing Chen |
| collection | DOAJ |
| description | Abstract Purposes In this study, we aimed to identify the distribution of presenting laboratory and nonenhanced computed tomography (CT) imaging features within 48 h before percutaneous cholecystostomy (PC) and create a model to appropriately guide the diagnosis of acute suppurative cholecystitis (ASC). Methods The study population included 204 acute cholecystitis patients who underwent PC. Based on the timing of the last laboratory and CT examinations before PC, the patients were divided into two groups: within 48 h before PC (Group 1, n = 138) and over 48 h before PC (Group 2, n = 63). The clinical features of the ASC patients in the two groups were compared. A multivariable model for the diagnosis of ASC in the patients in Group 1 was developed. Results Thirty-nine patients in Group 1 had ASC (28.3%). Gallbladder stones, common bile duct stones, gallbladder wall thickness > 2.85 mm, and neutrophil granulocytes > 82.55% were confirmed to be independent risk factors for ASC. The receiver operating characteristic curve of the recurrence prediction model verified its accuracy (area under the curve: 0.803). Compared with the ASC patients in Group 2, the ASC patients in Group 1 had a higher proportion of pericholecystic exudation or fluid (P = 0.013) and thicker gallbladder walls (P = 0.033). Conclusions Using nonenhanced CT imaging features and cutoffs for neutrophil granulocytes, we were able to identify a simple algorithm to discriminate ASC. The degree of local inflammation of the gallbladder in ASC patients progressively increases over time, and these changes can be observed on nonenhanced CT images. However, the symptoms of abdominal pain are of little help in estimating the disease duration in elderly patients. |
| first_indexed | 2024-12-21T05:16:54Z |
| format | Article |
| id | doaj.art-310b329060014e7bbdc6778bc00ee998 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-21T05:16:54Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-310b329060014e7bbdc6778bc00ee9982022-12-21T19:14:55ZengBMCBMC Gastroenterology1471-230X2022-03-0122111010.1186/s12876-022-02224-xValue of nonenhanced CT combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis treated with percutaneous cholecystostomy: a retrospective studyBai-Qing Chen0Feng Xie1Guo-Dong Chen2Xue Li3Xue Mao4Bao Jia5Department of Nuclear Medicine, The People’s Hospital of Liaoning ProvinceDepartment of Nuclear Medicine, The People’s Hospital of Liaoning ProvinceDepartment of Radiology, Panjin Liaohe Oilfield Gem Flower HospitalDepartment of Nuclear Medicine, The People’s Hospital of Liaoning ProvinceDepartment of Nuclear Medicine, The People’s Hospital of Liaoning ProvinceDepartment of Nuclear Medicine, The People’s Hospital of Liaoning ProvinceAbstract Purposes In this study, we aimed to identify the distribution of presenting laboratory and nonenhanced computed tomography (CT) imaging features within 48 h before percutaneous cholecystostomy (PC) and create a model to appropriately guide the diagnosis of acute suppurative cholecystitis (ASC). Methods The study population included 204 acute cholecystitis patients who underwent PC. Based on the timing of the last laboratory and CT examinations before PC, the patients were divided into two groups: within 48 h before PC (Group 1, n = 138) and over 48 h before PC (Group 2, n = 63). The clinical features of the ASC patients in the two groups were compared. A multivariable model for the diagnosis of ASC in the patients in Group 1 was developed. Results Thirty-nine patients in Group 1 had ASC (28.3%). Gallbladder stones, common bile duct stones, gallbladder wall thickness > 2.85 mm, and neutrophil granulocytes > 82.55% were confirmed to be independent risk factors for ASC. The receiver operating characteristic curve of the recurrence prediction model verified its accuracy (area under the curve: 0.803). Compared with the ASC patients in Group 2, the ASC patients in Group 1 had a higher proportion of pericholecystic exudation or fluid (P = 0.013) and thicker gallbladder walls (P = 0.033). Conclusions Using nonenhanced CT imaging features and cutoffs for neutrophil granulocytes, we were able to identify a simple algorithm to discriminate ASC. The degree of local inflammation of the gallbladder in ASC patients progressively increases over time, and these changes can be observed on nonenhanced CT images. However, the symptoms of abdominal pain are of little help in estimating the disease duration in elderly patients.https://doi.org/10.1186/s12876-022-02224-xAcute cholecystitisGallbladder empyemaPercutaneous cholecystostomyComputed tomographyLogistic regression |
| spellingShingle | Bai-Qing Chen Feng Xie Guo-Dong Chen Xue Li Xue Mao Bao Jia Value of nonenhanced CT combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis treated with percutaneous cholecystostomy: a retrospective study BMC Gastroenterology Acute cholecystitis Gallbladder empyema Percutaneous cholecystostomy Computed tomography Logistic regression |
| title | Value of nonenhanced CT combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis treated with percutaneous cholecystostomy: a retrospective study |
| title_full | Value of nonenhanced CT combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis treated with percutaneous cholecystostomy: a retrospective study |
| title_fullStr | Value of nonenhanced CT combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis treated with percutaneous cholecystostomy: a retrospective study |
| title_full_unstemmed | Value of nonenhanced CT combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis treated with percutaneous cholecystostomy: a retrospective study |
| title_short | Value of nonenhanced CT combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis treated with percutaneous cholecystostomy: a retrospective study |
| title_sort | value of nonenhanced ct combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis treated with percutaneous cholecystostomy a retrospective study |
| topic | Acute cholecystitis Gallbladder empyema Percutaneous cholecystostomy Computed tomography Logistic regression |
| url | https://doi.org/10.1186/s12876-022-02224-x |
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