ArticleCureus2026
Diagnostic Concordance of CT and Ultrasound With Operative Findings in Acute Cholecystitis: A Retrospective Cohort Study.
Article in Cureus, 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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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
Background Acute cholecystitis (AC) is a common surgical emergency. Ultrasound (US) is the preferred initial imaging study, while CT is often used when findings are unclear. Reported imaging performance, however, varies. This study evaluated relationships among imaging, surgical, and pathological findings in patients who underwent cholecystectomy for acute disease. Methods This single-center retrospective review included 224 adults who underwent cholecystectomy between January 2020 and January 2025, with pathology-confirmed acute, acute-on-chronic, or gangrenous cholecystitis. Eligible patients received US, CT, or both within 48 hours before surgery. Imaging was considered positive if two or more inflammatory features were documented or if the radiologist's impression indicated acute disease, including equivocal but concerning language. Operative and pathological findings served as reference standards. Sensitivity, concordance, and 95% CIs were calculated. Sensitivities were compared using two-proportion z-tests, McNemar's test for paired data, and Cohen's kappa (κ) for inter-modality agreement. Results CT showed higher sensitivity than US (126/176 (71.5%) vs 93/156 (59.6%); z = 2.30, p = 0.022) and similar concordance with operative findings. Among 108 patients who underwent both modalities, 24 (22.2%) had discordant results. CT was significantly more likely than US to agree with operative findings (McNemar's χ² = 8.17, p = 0.004). Inter-modality agreement was moderate (κ = 0.53, 95% CI 0.37-0.69). Sensitivity in gangrenous cases was lower than overall sensitivity for both CT (15/29 (51.7%)) and US (6/24 (25.0%); z = 1.98, p = 0.048). Conclusions In this surgically managed cohort, CT and US provided complementary information. CT demonstrated better concordance with operative findings and modestly higher sensitivity, particularly in gangrenous cholecystitis, although the clinical significance remains uncertain. US remains the appropriate first-line imaging modality, with CT serving a complementary role in selected patients.
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