Power Versus Conventional Color Doppler Sonographic Diagnosis Of Acute Cholecystitis: Comparison In The Depiction Of Mural Flow

Abstract

Background: Gray-scale sonography is generally
considered as a first-line diagnostic tool for patient with
suspected acute cholecystitis. It is suggested by gallstones,
Murphy's sign, thickening of the gallbladder wall and bile
sludging, but the specificity of these sonographic findings
are not as high as their sensitivity. Blood flow of the
gallbladder wall is increased in acute inflammation.
Objective: To evaluate the sensitivity and specificity of
power Doppler sonography and compared with conventional
color Doppler and gray-scale sonography in diagnosing
patients with acute cholecystitis.
Type of the study: This was a cross sectional study.
Patients and methods: The study was conducted through
the period from August 2014 to August 2015 on 80 patients
with acute right upper quadrant abdominal pain and
clinically suspected acute cholecystitis. Firstly, gray-scale
sonography of the abdomen was performed. Next, color
Doppler and power Doppler sonography of the gallblader
wall was done to detect mural flow. Quantifying intramural
vascularity was performed using Uggowitzer scoring
system. Grading of vascularity ++ and +++ were suggestive
of acute cholecystitis. Results of gray-scale and Doppler
sonography were compared with post cholecystectomy
histopathological results.