Logo image
Back
Ultrasound cystic artery velocity as a predictor for acute cholecystitis in patients presenting to the emergency department
Journal article   Open access   Peer reviewed

Ultrasound cystic artery velocity as a predictor for acute cholecystitis in patients presenting to the emergency department

Saubhagya Srivastava, Manish Dhyani, Manjiri Dighe, Tushar Kumar, David T. Fetzer, Guilherme M. Cunha and Theodore J. Dubinsky
Abdominal radiology (New York), Vol.51(5), pp.2398-2409
05/2026
DOI: 10.1007/s00261-025-05216-z
PMCID: PMC13061786
PMID: 41081877
Appears in  UI Libraries Support Open Access
url
https://doi.org/10.1007/s00261-025-05216-zView
Published (Version of record) Open Access

Abstract

Background Acute cholecystitis (AC) is a common yet challenging diagnosis in the emergency department (ED), with diverse sonographic parameters employed to enhance diagnostic accuracy. Recently, peak systolic cystic artery velocity (CaV) >= 40 cm/s has been proposed as a highly specific and an independent sonographic marker for AC in the emergency setting. Objective To evaluate the diagnostic performance of CaV for AC and to assess the diagnostic utility of additional ultrasound parameters for the diagnosis of AC in the ED. Methods This retrospective, single-institutional study analyzed ultrasound exams from 405 patients over one year. CaV was compared in patients diagnosed with AC on surgical pathology versus controls (subjects without presumed AC), employing statistical tools for data analysis including assessment of diagnostic efficacy of sonographic markers and multivariate logistic regression to assess true sonographic predictors of AC. Results CaV >= 40 cm/s demonstrated specificity and negative predictive value of 83.8% and 91.3%, respectively, but lower sensitivity and positive predictive value of 58.5% and 40.9%, respectively. The ROC curve analysis for CaV yielded an area under the curve of 0.771. On multivariate analysis several sonographic features showed significant predictors of AC in the ED, including CaV, gallbladder wall thickness, longitudinal length, presence of gallstones, and a positive sonographic Murphy's sign. Conclusion While CaV shows promise as a diagnostic marker, its utility should only be considered alongside other sonographic parameters due to its low independent sensitivity and positive predictive value. The sonographic diagnosis of AC in the ED continues to rely on a multiparametric approach to enhance diagnostic efficacy, ensuring more accurate and timely diagnosis of AC in the ED.
 Life Sciences & Biomedicine Radiology, Nuclear Medicine & Medical Imaging Science & Technology UIOWA OA Agreement

Details

Metrics

9 Record Views
Logo image