What are the useful imaging modalities to investigate cholecystitis?
Indicate the utility of each imaging procedure and when you would select each one:
What are the imaging findings of cholecystitis in four views abdomen?


Plain film

Gall stone in a patient with ankylosing spondylitis




Emphysematous cholecystitis

Air in the lumen of Gall bladder

Emphysematous Cholecystitis

Radiograph showing:

  • Arrow points to air within the lumen of GB.
  • Arrowheads point to air in the GB wall.






What are the imaging findings of acute cholecystitis in ultrasound abdomen?

Ultrasound findings:

Gallstones - Acute cholecystitiss

US findings:

  • Thick GB wall
  • Stones in GB
  • Absence of echoes posterior to the calculi "Shadowing"




Acute Emphysematous Cholecystitis

Ultrasound showing:

  • Thick wall of GB
  • Stones in GB
  • Air in GB
  • Air in wall of GB is bright like a stone but has no shadow posteriorly, and has ring down artifact.



Emphysematous Cholecystitis


Arrows point to ring down artifacts from air in the wall and lumen of GB.






Acute acalculous Cholecystitis

US Finding:

Thickened gallbladder wall






What are the imaging findings of acute cholecystitis in radionucleotide cholescintigraphy (HIDA Scan)? .
What are the imaging findings of acute cholecystitis in CT abdomen?

Acute Cholecystitis

CT showing:

  • Thick wall of gallbladder
  • Multiple tiny calculi in gallbladder







Emphysematous cholecystitis

Emphysematous Cholecystitis

CT Findings:

  • Air in the wall of GB
  • GB calculi







Sensitivity and specificity of each:
What is the procedure sequence/ diagnostic algorithm in a suspected case of acute cholecystitis?