Ultrasound Cystic Artery Velocity as a Predictor for Acute Cholecystitis

Researchers from the University of Washington have proposed a new sonographic marker for the diagnosis of acute cholecystitis in the emergency department. According to a recent study, peak systolic cystic artery velocity (CaV) of 40 cm/s has been found to be highly specific and an independent sonographic marker for acute cholecystitis. However, the utility of CaV should only be considered alongside other sonographic parameters due to its low independent sensitivity and positive predictive value.

Key Takeaways:

• The study analyzed ultrasound exams from 405 patients over one year, with CaV being compared in patients diagnosed with acute cholecystitis on surgical pathology versus controls.
• CaV 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.
• Multivariate analysis showed that several sonographic features, including CaV, gallbladder wall thickness, longitudinal length, presence of gallstones, and a positive sonographic Murphy's sign, were significant predictors of acute cholecystitis in the ED.
• The sonographic diagnosis of acute cholecystitis in the ED continues to rely on a multiparametric approach to enhance diagnostic efficacy.

Statistics:

• 405 patients were analyzed in the study over a period of one year.
• CaV 40 cm/s had a specificity of 83.8% and a negative predictive value of 91.3%.
• CaV 40 cm/s had a sensitivity of 58.5% and a positive predictive value of 40.9%.
• The area under the curve for CaV was 0.771.

Sources:

• Abdominal Radiology, 2025
• NewsRx, New Acute Cholecystitis Study Findings Have Been Reported by Researchers at University of Washington (Ultrasound cystic artery velocity as a predictor for acute cholecystitis in patients presenting to the emergency department).