We have located links that may give you full text access.
Journal Article
Research Support, Non-U.S. Gov't
Pope's hat sign: another valuable CT finding of early acute cholecystitis.
Abdominal Radiology 2018 July
PURPOSE: To determine the diagnostic performance of minor computed tomography (CT) findings for acute cholecystitis and demonstrate the incremental benefit of pope's hat sign as an additional minor CT finding in patients suspected to have early acute cholecystitis.
MATERIALS AND METHODS: Two radiologists reviewed CT scans of 116 patients with early acute cholecystitis and 116 control patients. All cases in the patient group were surgically proven to have acute cholecystitis and preoperative dynamic CT scans. Evaluated CT parameters included major criteria (gallstone, distension of gallbladder (GB) lumen, GB wall edema, pericholecystic fat infiltration, and pericholecystic fluid collection) and minor criteria (GB bed hyperemia, tensile GB fundus sign, hyperdense GB wall sign, increased bile attenuation within GB, and pope's hat sign).
RESULTS: In a univariate analysis, among the minor criteria, GB bed hyperemia, tensile GB fundus sign, increased bile attenuation within GB, and pope's hat sign were more frequently observed (P < 0.05) in the early acute cholecystitis group. The optimal cut-off value of GB distension for discriminating between the two groups was 3.05 cm. In a multivariable analysis, GB bed hyperemia, pope's hat sign, and GB lumen > 3.05 cm were significant findings for differentiating the two groups (P < 0.001). Among all combinations of these findings, the combination of GB bed hyperemia and pope's hat sign exhibited the highest specificity (96.5%) and the combination of all three findings showed the highest sensitivity (94.0%).
CONCLUSION: Pope's hat sign is a new finding that could improve CT diagnostic performance for early acute cholecystitis in patients with RUQ pain in the emergency department. The combination of pope's hat sign with GB bed hyperemia or GB lumen distension > 3.05 cm may be even more helpful in the early stage or in mild forms of acute cholecystitis.
MATERIALS AND METHODS: Two radiologists reviewed CT scans of 116 patients with early acute cholecystitis and 116 control patients. All cases in the patient group were surgically proven to have acute cholecystitis and preoperative dynamic CT scans. Evaluated CT parameters included major criteria (gallstone, distension of gallbladder (GB) lumen, GB wall edema, pericholecystic fat infiltration, and pericholecystic fluid collection) and minor criteria (GB bed hyperemia, tensile GB fundus sign, hyperdense GB wall sign, increased bile attenuation within GB, and pope's hat sign).
RESULTS: In a univariate analysis, among the minor criteria, GB bed hyperemia, tensile GB fundus sign, increased bile attenuation within GB, and pope's hat sign were more frequently observed (P < 0.05) in the early acute cholecystitis group. The optimal cut-off value of GB distension for discriminating between the two groups was 3.05 cm. In a multivariable analysis, GB bed hyperemia, pope's hat sign, and GB lumen > 3.05 cm were significant findings for differentiating the two groups (P < 0.001). Among all combinations of these findings, the combination of GB bed hyperemia and pope's hat sign exhibited the highest specificity (96.5%) and the combination of all three findings showed the highest sensitivity (94.0%).
CONCLUSION: Pope's hat sign is a new finding that could improve CT diagnostic performance for early acute cholecystitis in patients with RUQ pain in the emergency department. The combination of pope's hat sign with GB bed hyperemia or GB lumen distension > 3.05 cm may be even more helpful in the early stage or in mild forms of acute cholecystitis.
Full text links
Related Resources
Trending Papers
British Society of Gastroenterology guidelines for the management of hepatocellular carcinoma in adults.Gut 2024 April 17
Systemic lupus erythematosus.Lancet 2024 April 18
Should renin-angiotensin system inhibitors be held prior to major surgery?British Journal of Anaesthesia 2024 May
Ventilator Waveforms May Give Clues to Expiratory Muscle Activity.American Journal of Respiratory and Critical Care Medicine 2024 April 25
Acute Kidney Injury and Electrolyte Imbalances Caused by Dapagliflozin Short-Term Use.Pharmaceuticals 2024 March 27
Colorectal polypectomy and endoscopic mucosal resection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2024.Endoscopy 2024 April 27
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app