ArticleAbdominal radiology (New York)2026
Ultrasound cystic artery velocity as a predictor for acute cholecystitis in patients presenting to the emergency department.
Article in Abdominal radiology (New York), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAcute 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.
objectiveTo 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.
methodsThis 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.
resultsCaV ≥ 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.
conclusionWhile 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.
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