Hepatobiliary scintigraphy is superior to abdominal ultrasonography in suspected acute cholecystitis

Background. Hepatobiliary scintigraphy is a very accurate test in the diagn osis of acute cholecystitis. However ultrasonography is extensively used fo r the diagnosis of this disease. In this study we directly compare the diag nostic accuracy of these techniques for acute cholecystitis. Materials and Methods. The diagnostic accuracy of scintigraphy and ultrason ography was evaluated in 107 consecutive patients with suspected acute chol ecystitis who underwent both imaging nodalities within one day. The increme ntal diagnostic value of each modality was determined. Results. The sensitivity, specificity positive and negative predictive valu es, and accuracy for the diagnosis of acute cholecystitis in the entire coh ort were superior for scintigraphy compared with ultrasonography. The accur acy wets 92 % for scintigraphy and 77 % for ultrasonography. Similarly, if only surgically treated patients were considered, the accuracy of scintigra phy was 91 % versus 61 % for ultrasonography. The diagnostic value of scint igraphy for the entire cohort was significantly superior to ultrasonography (global, chi 2 = 58.1 vs 9.7, respectively); the addition of the informati on derived from the latter did not futher improve the diagnostic value of s cintigraphy (global, chi 2 = 58.2). Conclusions. Hepatobiliary scintigraphy has superior diagnostic accuracy fo r acute cholecystitis compared with ultrasonography. The addition of ultras onography does not further improve the diagnostic accuracy of scintigraphy alone.