Serdar TARHAN, Mine ÖZKOL, Aslan SAKARYA, Yavuz KAYA, Semin AYHAN, Cihan GÖKTAN

Akut kolesistitin tanısında power Doppler ultrasonografik-patolojik korelasyon

Power Doppler ultrasonografi nispeten hız ve açıdan bağımsız, küçük vasküler yapıları ve yavaş akımları göstermede renkli Doppler ultrasonografiden üstün yeni bir Doppler inceleme yöntemidir. Bu çalışmadaki amaç; power Doppler ultrasonografinin akut kolesistitin tanısına ve kronik kolesistit He ayırıcı tanısına katkılarını araştırmaktır. Sağ üst kadran ağrısı şikayeti olan veya klinik olarak kolesistit olduğu düşünülen 120 hastada konvansiyonel gri skala ultrasonografiye ilave olarak renkli Doppler ultrasonografi ve Power Doppler ultrasonografi He safra kesesi duvar kanlanması incelendi. Bunlardan öpere edilen 48 hastanın sonografi bulguları ile histopatolojik bulguları karşılaştırıldı. Histopatolojik olarak öpere edilen 48 hastanın 23'ünde akut kolesistit, 25'inde kronik kolesistit saptandı. Power Doppler ultrasonografi ile akut kolesistitli 23 hastanın 22'sinde (% 95) safra kesesi duvarında hipervaskülarite saptandı. Akut kolesistitin tanısında power Doppler ultrasonografinin sensitivitesi %95 ve spesifisitesi %100 idi. Sonuç olarak Power Doppler ultrasonografi akut kolesistitli hastaların tanısında ve kronik kolesistitden ayrımında oldukça duyarlı bir yöntemdir. Kolesistitten şüphelenilen hastalarda gri skala ultrasonografinin tanısal değerini arttırmak için rutin olarak kullanılmalıdır.

Anahtar Kelimeler:

Ultrasonografi, Kolesistit, Tanısal görüntüleme, Duyarlılık ve özgüllük, Ultrasonografi, doppler

Diagnosis of acute cholecystitis with power Doppler us: Comparison of sonography-pathology

Power Doppler ultrasonography is a new Doppler examination technique which is relatively independent from flow and angle, and it is superior to color Doppler ultrasonography to display small vessels and slow lows. The aim of this study was to investigate the role of Power Doppler ultrasonography in diagnosing acute cholecystitis and differentiating acute from chronic cholecystitis. In one hundred twenty patients with acute right upper quadrant pain or clinically suspected cholecystitis, gallbladder wall vascularity underwent color Doppler ultrasonography and Power Doppler ultrasonography as an adjunct to gray-scaleultrasonography. Imaging findings were compared with pathologic findings in the 48 patients who underwent cholecystectomy. In histopathologic examinations of the operated 48 patients, 23 patients had acute cholecystitis, 25 patients had chronic cholecystitis. With power Doppler ultrasonography, 22 (95%) of 23 patients with acute cholecystitis had hypervascularity in gallbladder wall. Sensitivity and specificity of Power Doppler ultrasonography for revealing acute cholecystitis were 95% and 100%, respectively. As a result, Power Doppler ultrasonography is a very sensitive method for diagnosing acute cholecystitis and differentiating it from chronic cholecystitis. It should be routinely performed in patients with suspected cholecystitis to improve the diagnostic capabilities of gray-scale ultrasonography.

Keywords:

Ultrasonography, Cholecystitis, Diagnostic Imaging, Sensitivity and Specificity, Ultrasonography, Doppler,

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