CT without IV contrast can detect some features and complications of AC, such as gallbladder wall thickening, pericholecystic inflammation, gas formation, and hemorrhage, although some important features, such as wall enhancement and adjacent liver parenchymal hyperemia, cannot be detected without IV contrast. Adjacent liver hyperemia is actually one of the earlier findings in AC and can be a very useful problem-solving tool [7]. CT without and with IV contrast is not often viewed as helpful in assessing patients admitted with right upper quadrant abdominal pain. Little additional information is gained by the routine addition of a noncontrast phase to a contrast-enhanced phase in this clinical setting, [10]. MRI Abdomen with MRCP The presence of AC can be further explored using abdominal MRI, which often includes the use of an IV gadolinium-based contrast agent in cases in which other imaging tests are equivocal [7]. Several studies have suggested that abdominal MRI is a reliable alternative and can be particularly helpful in the patient who is difficult to examine with US [36-38]. It can perform superiorly to US in cases of gallstones in the gallbladder neck, the cystic duct, or the common bile duct [7]. As with CT without IV contrast, noncontrast MRI will not be able to detect all the imaging features or potential complications of AC. However, noncontrast MRI with MRCP has excellent accuracy for the detection of biliary stone disease, and, therefore, a noncontrast MRI is generally preferred over a noncontrast CT. Nuclear Medicine Scan Gallbladder Despite providing information limited to the hepatobiliary tract, cholescintigraphy has been advocated as a useful modality in this setting. Specifically, gallbladder nonvisualization with delayed imaging or morphine-augmented cholescintigraphy is highly accurate for evaluating the presence or absence of AC.
Right Upper Quadrant Pain. CT without IV contrast can detect some features and complications of AC, such as gallbladder wall thickening, pericholecystic inflammation, gas formation, and hemorrhage, although some important features, such as wall enhancement and adjacent liver parenchymal hyperemia, cannot be detected without IV contrast. Adjacent liver hyperemia is actually one of the earlier findings in AC and can be a very useful problem-solving tool [7]. CT without and with IV contrast is not often viewed as helpful in assessing patients admitted with right upper quadrant abdominal pain. Little additional information is gained by the routine addition of a noncontrast phase to a contrast-enhanced phase in this clinical setting, [10]. MRI Abdomen with MRCP The presence of AC can be further explored using abdominal MRI, which often includes the use of an IV gadolinium-based contrast agent in cases in which other imaging tests are equivocal [7]. Several studies have suggested that abdominal MRI is a reliable alternative and can be particularly helpful in the patient who is difficult to examine with US [36-38]. It can perform superiorly to US in cases of gallstones in the gallbladder neck, the cystic duct, or the common bile duct [7]. As with CT without IV contrast, noncontrast MRI will not be able to detect all the imaging features or potential complications of AC. However, noncontrast MRI with MRCP has excellent accuracy for the detection of biliary stone disease, and, therefore, a noncontrast MRI is generally preferred over a noncontrast CT. Nuclear Medicine Scan Gallbladder Despite providing information limited to the hepatobiliary tract, cholescintigraphy has been advocated as a useful modality in this setting. Specifically, gallbladder nonvisualization with delayed imaging or morphine-augmented cholescintigraphy is highly accurate for evaluating the presence or absence of AC.