COLOR VELOCITY IMAGING AND POWER DOPPLER SONOGRAPHY OF THE GALLBLADDER WALL - A NEW LOOK AT SONOGRAPHIC DIAGNOSIS OF ACUTE CHOLECYSTITIS

OBJECTIVE. Color velocity imaging is a color sonographic technique tha t uses data contained in gray-scale B-mode image scan lines to determi ne blood flow velocity. We prospectively determined if color velocity imaging and power Doppler sonography can be used to differentiate acut e from chronic cholecystitis. We analyzed the potential role of using these two color imaging techniques as an adjunct to conventional gray- scale sonography to differentiate acute from chronic cholecystitis. SU BJECTS AND METHODS. One hundred twenty-nine patients with acute right upper quadrant pain or clinically suspected cholecystitis underwent co lor velocity imaging and power Doppler sonography of the gallbladder a s an adjunct to gray-scale sonography. Morphologic criteria were analy zed on gray-scale sonography, and the presence of flow within the gall bladder wall was assessed with color velocity imaging and power Dopple r sonography. Imaging findings were compared with pathologic findings in the 50 patients who underwent cholecystectomy and with clinical and biologic findings in the 79 patients who did not undergo cholecystect omy. RESULTS. Twenty-two patients had surgically proven acute cholecys titis, 28 patients had surgically proven chronic cholecystitis, and 79 patients had no gallbladder disease. Sensitivity, specificity, accura cy, positive predictive value, and negative predictive value of gray-s cale sonography for revealing acute cholecystitis were 86%, 99%, 92%, 87%, and 97%, respectively. Sensitivity, specificity, accuracy, positi ve predictive value, and negative predictive value of color velocity i maging and power Doppler sonography for revealing acute cholecystitis were 95%, 100%, 99%, 100%, and 99%, respectively. CONCLUSION.The accur acy of color velocity imaging and power Doppler sonography in revealin g acute cholecystitis is significantly greater than the accuracy of gr ay-scale sonography.