The efficiency of apparent diffusion coefficient quantification in diagnosis of acute cholecystitis and in differentiation of cholecystitis from extrinsic benign gallbladder wall thickening

Jpn J Radiol. 2014 Sep;32(9):545-51. doi: 10.1007/s11604-014-0343-8. Epub 2014 Jun 28.

Abstract

Purpose: The aim of the current study was to assess the efficiency of the apparent diffusion coefficient (ADC) measurement in diagnosis of acute cholecystitis and in differentiation of cholecystitis from extrinsic benign gallbladder wall thickening.

Methods: Forty patients who were diagnosed to have acute cholecystitis by ultrasonographic examination were included in this study. The control group consisted of 18 patients without symptoms of gallstones and cholecystitis whose gallbladder walls were thickened due to cirrhotic ascites. Both groups were examined using diffusion weighted imaging, and the mean ADC values were compared using Student's t-test.

Results: The diagnoses of the 40 patients were proven by histopathological examination. The mean ADC values of patients diagnosed with cholecystitis (1.68 ± 0.36 × 10(-3) mm(2)/s) were significantly lower than the mean ADC values of the control group (2.35 ± 0.24 × 10(-3) mm(2)/s) (p < 0.05). Receiver operating characteristics curve analysis based on ADC revealed a cut-off value of 2.04 × 10(-3) mm(2)/s for the diagnosis of cholecystitis, with a sensitivity of 94% and a specificity of 89.7%.

Conclusion: ADC value quantification may be an efficient method for making a diagnosis of cholecystitis and in differential diagnosis of cholecystitis from the extrinsic benign gallbladder wall thickening that can be seen during the course of cirrhotic ascites.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cholecystitis / diagnosis
  • Cholecystitis, Acute / diagnosis*
  • Diagnosis, Differential
  • Diffusion Magnetic Resonance Imaging / methods*
  • Echo-Planar Imaging / methods
  • Female
  • Gallbladder / pathology*
  • Gallbladder Diseases / diagnosis
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Male
  • Middle Aged
  • Prospective Studies
  • ROC Curve
  • Sensitivity and Specificity