Radiologic features of symptomatic cholelithiasis: a current perspective

Year 2020, Volume: 3 Issue: 4, 466 - 472, 22.10.2020

Adnan Özdemir , Mehmet Hamdi Şahan

https://doi.org/10.32322/jhsm.795078

Cited By: 1

Abstract

Introduction / Aim: The aim of this study was to use radiography, ultrasonography (US), and computed tomography (CT) to investigate the radiological features of symptomatic cholelithiasis.
Material and Method: From January 2014 and September 2019, 543 patients with cholelithiasis were identified. Of these, 174 who also underwent radiography and CT were included in the study. During the 3-year follow-up of the 174 patients, 80 patients had symptomatic cholelithiasis, identified according to US and/or CT examinations, as well as clinical findings. Cholecystitis, cholangitis, pancreatitis, and choledocholithiasis findings were considered symptomatic. Radio-opaque stones were identified on radiography and stones were visible on CT. The stones were divided into groups according to their calcification types. The Hounsfield unit (HU) values of the stones were measured and the number and size of the stones were determined by CT and US.
Findings / Results: Symptomatic findings included radio-opaque stones, multiple stones, stones with HU values above 100 HU, and cholelithiasis of the uniform calcification type (P <0.05). However, the relationship between symptomatic cholelithiasis and stone size was not significant (P>0.05).
Conclusion: The radiological features of symptomatic cholelithiasis are important in terms of follow-up, treatment plan and prevention of complications.

Keywords

radio-opaque, symptomatic, complication, Cholelithiasis

Semptomatik kolelitiyazisin radyolojik özellikleri: güncel bir bakış

Abstract

Giriş / Amaç: Bu çalışmanın amacı, semptomatik kolelitiyazisin radyolojik özelliklerini araştırmak için radyografi, ultrasonografi (US) ve bilgisayarlı tomografi (BT) kullanmaktı.
Gereç ve Yöntem: Ocak 2014 ve Eylül 2019'dan itibaren 543 kolelitiyazisli hasta belirlendi. Bunlardan hem radyografi, hem de BT’si çekilen 174'ü çalışmaya dahil edildi. 174 hastanın 3 yıllık takibinde 80 hastada US ve / veya BT incelemelerine ve klinik bulgulara göre tespit edilen semptomatik kolelitiyazis vardı. Kolesistit, kolanjit, pankreatit ve koledokolitiazis bulguları semptomatik olarak kabul edildi. Radyografide radyoopak taşlar belirlendi ve BT'de taşlar görüldü. Taşlar kalsifikasyon türlerine göre gruplara ayrıldı. Taşların Hounsfield birimi (HU) değerleri ölçülerek taş sayısı ve boyutu CT ve US tarafından belirlendi.
Bulgular ve Sonuç: Radyoopak taşlar, çoklu taşlar, HU değerleri 100 HU'nun üzerinde olan taşlar ve tek tip kalsifikasyon tipinde safra taşlarında semptomatik bulgular vardı (P <0.05). Ancak semptomatik kolelitiazis ile taş boyutu arasındaki ilişki anlamlı değildi (P> 0.05). Semptomatik kolelitiyazisin radyolojik özellikleri takip, tedavi planı ve komplikasyonların önlenmesi açısından önemlidir.

Keywords

radyoopak, Semptomatik, Komplikasyon, Kolelitizis

References

• Catalano OA, Sahani DV, Kalva SP, et al. MR imaging of the gallbladder: a pictorial essay. Radiographics 2008; 28: 135-55.
• Federle MP and Raman SP. Diagnostic Imaging: Gastrointestinal E-Book. Elsevier Health Sciences 2015.
• Rumack CM, Wilson S, Charboneau JW, Levine D. Diagnostic Ultrasound: 2-Volume Set. Missouri: Elsevier Mosby 2010.
• EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones. J Hepatol 2016; 65: 146-81.
• Bellows CF, BErGEr DH and Crass RA. Management of gallstones. Am Fam Physician 2005; 72: 637-42.
• Tazuma S, Unno M, Igarashi Y, et al. Evidence-based clinical practice guidelines for cholelithiasis 2016. J Gastroenterol 2017; 52: 276-300.
• Tsai HM, Lin XZ, Chen CY, Lin PW, Lin JC. MRI of gallstones with different compositions. AJR Am J Roentgenol 2004; 182: 1513-9.
• Njeze GE. Gallstones. Niger J Surg 2013; 19: 49-55.
• Trotman BW. Pigment gallstone disease. Gastroenterol Clin North Am 1991; 20: 111-26.
• Trotman BW, Petrella EJ, Soloway RD, Sanchez HM, Morris TA 3rd, Miller WT. Evaluation of radiographic lucency or opaqueness of gallstones as a means of identifying cholesterol or pigment stones. Correlation of lucency or opaqueness with calcium and mineral. Gastroenterology 1975; 68: 1563-6.
• Chan WC, Joe BN, Coakley FV, et al. Gallstone detection at CT in vitro: effect of peak voltage setting. Radiology 2006; 241: 546-53.
• Stewart L, Griffiss JM and Way LW. Spectrum of gallstone disease in the veterans population. Am J Surg 2005; 190: 746-51.
• Venneman NG and van Erpecum KJ. Pathogenesis of gallstones. Gastroenterol Clin 2010; 39: 171-83.
• Brink JA, Kammer B, Mueller PR, Balfe DM, Prien EL, Ferrucci JT. Prediction of gallstone composition: synthesis of CT and radiographic features in vitro. Radiology 1994; 190: 69-75.
• Dolgin SM, Schwartz JS, Kressel HY, et al. Identification of patients with cholesterol or pigment gallstones by discriminant analysis of radiographic features. New Eng Jo Med 1981; 304: 808-11.
• Plaisier PW, Brakel K, van der Hul RL, Bruining HA. Radiographic features of oral cholecystograms of 448 symptomatic gallstone patients: implications for nonsurgical therapy. Eur J Radiol 1994; 18: 57-60.
• Ros E, Valderrama R, Bru C, Bianchi L, Teres J. Symptomatic versus silent gallstones. Radiographic features and eligibility for nonsurgical treatment. Dig Dis Sci 1994; 39: 1697-703.
• Demehri FR and Alam HB. Evidence-Based Management of Common Gallstone-Related Emergencies. J Intensive Care Med 2016; 31: 3-13.
• Raptopoulos V, Compton CC, Doherty P, et al. Chronic acalculous gallbladder disease: multiimaging evaluation with clinical-pathologic correlation. Am J Roentgenol 1986; 147: 721-4.
• Fidler J, Paulson EK and Layfield L. CT evaluation of acute cholecystitis: findings and usefulness in diagnosis. Am J Roentgenol 1996; 166: 1085-8.
• O’Kane D, Papa N, Manning T, et al. Contemporary Accuracy of Digital Abdominal X-Ray for Follow-Up of Pure Calcium Urolithiasis: Is There Still a Role? J Endourol 2016; 30: 844-9.
• Ozbalci G, Tanrikulu Y, Kismet K, Dinc S, Akkus M. Gallstone ileus with a giant stone and associated multiple stones. Bratisl Lek Listy 2012; 113: 503-5.