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Journal of Ultrasound in Medicine, Vol 14, Issue 1 33-36, Copyright © 1995 by American Institute of Ultrasound in Medicine


JOURNAL ARTICLE

Color Doppler sonography of the cystic artery: comparison of normal controls and patients with acute cholecystitis

R. B. Jeffrey Jr, M. Nino-Murcia, P. W. Ralls, K. A. Jain and H. C. Davidson
Department of Radiology, Stanford University Medical Center, CA 94305, USA.

Color Doppler sonography was used to evaluate the length and distribution of the cystic artery in the gallbladder wall in 115 normal adults and in 54 patients with surgically proved cholecystitis. All patients were scanned with a 5 MHz curved array transducer optimized for low volume color sensitivity. A specific attempt was made to visualize the cystic artery throughout its course. Spectral Doppler waveforms were obtained to document arterial flow. The length of the cystic artery visualized was analyzed as a quartile percentage length of the anterior gallbladder wall. The distribution of the cystic artery flow also was analyzed in specific quartiles. Of 54 patients with acute cholecystitis, 26% had cystic artery length greater than half of the anterior gallbladder wall, compared with 2% of 115 normal controls (P < 0.001); 19% of patients with cholecystitis had flow in the distal (fundal) quartile, compared to 0% of normal controls (P < 0.0001). Although the presence or absence of flow in the gallbladder is not a reliable finding to establish the diagnosis of acute cholecystitis, length of cystic artery visualized is a potentially useful criterion to suggest the diagnosis of acute cholecystitis, especially in cases in which flow in the distal fundal quartile of the gallbladder. The usefulness of color Doppler sonography in acute cholecystitis is limited owing to the fact that it is insensitive, and many patients with cholecystitis have no detectable flow or have normal flow patterns.


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G. W. L. Boland, G. Slater, D. S. K. Lu, P. Eisenberg, M. J. Lee, and P. R. Mueller
Prevalence and Significance of Gallbladder Abnormalities Seen on Sonography in Intensive Care Unit Patients
Am. J. Roentgenol., April 1, 2000; 174(4): 973 - 977.
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