Cystic Artery Velocity: Evaluation of Performance in the Sonographic Diagnosis of Acute Cholecystitis.

RATIONALE AND

OBJECTIVES

Cystic artery velocity (CAV) has emerged as a promising sonographic parameter in diagnosing acute cholecystitis. This study aimed to evaluate performance of CAV and other sonographic findings in diagnosing acute cholecystitis.

MATERIALS AND

METHODS

In this Institutional Review Board-approved single-center retrospective case-control study, ultrasound exams of patients suspected to have acute cholecystitis from January 2017 to June 2024 were categorized into three groups: acute cholecystitis (AC), chronic cholecystitis (CC), and no acute cholecystitis (NAC). AC and CC diagnoses were confirmed by surgical pathology. The NAC group was determined based on clinical grounds. We evaluated performance of CAV and other sonographic features in differentiating between AC vs NAC, and AC vs CC. Optimal CAV cutoffs to help rule in and rule out acute cholecystitis were found.

RESULTS

There were 831 patients in the AC group (mean age, 53.1±17.8 years; 426 females), 713 in the CC group (mean age, 42.5±17.5 years; 557 females), and 701 in the NAC group (mean age, 52.3±19.9 years; 394 females). A CAV cutoff of ≥42.6 cm/s achieved PPVs of 77.3% (95% confidence interval (CI) 72.3-81.9) in differentiating AC from NAC, and 65.0% (55.0-77.6) in differentiating AC from CC. A CAV cutoff of <24.6 cm/s achieved NPVs of 87.9% (79.0-97.2) in differentiating AC from NAC, and 84.0% (68.7-96.4) in differentiating AC from CC.

CONCLUSION

Different CAV cutoffs can help rule in and rule out acute cholecystitis in different clinical scenarios but should be used in combination with other sonographic and clinical findings to improve the diagnosis of acute cholecystitis.