EVALUATION OF BLOOD FLOW PARAMETERS IN THE GALLBLADDER WALL VIA DOPPLER ULTRASONOGRAPHY IN PATIENTS WITH ACUTE CALCULOUS CHOLECYSTITIS

Abstract

According to the national clinical guidelines of the Russian Society of Surgeons ultrasound examination of the gallbladder is the one of the most important methods for diagnostic of acute cholecystitis. Sonographic signs of the disease, as an increase in bladder sizes, changes of wall structure and wall thickness, Doppler signs of wall hypervascularization, are well known.The aim of the study was to find new ultrasound color and power Doppler signs of acute cholecystitis. The analysis of 144 USprocedures showed the greatest importance of increasing of systolic maximum velocity (Vmax) flow in cystic artery branches into the gallbladder wall, regardless of in which of the 4 segments the vessel was visualized. The peak systolic velocity (Vmax) increase by 80% compared with the norm in patients with vessels visualized only in I and/or II gallbladder segments has a positive predictive value of 95% for the diagnosis of acute cholecystitis. Our analysis showed no intersegmental differences in Vmax, that allows us to measure these parameters in one of segments, but not in each of them. PG pressure gradient had the highest values in segment II and the lowest values in segment IV (the fundus of gallbladder). Our results are presented for the first time and have a goal in clarifying the Color and Power Doppler ultrasound procedure of the gallbladder and the estimation of blood flow parameters in acute cholecystitis.