An updated overview of ultrasound (US) for diagnosis of acute cholecystitis (AC) remains lacking. This systematic review was conducted to evaluate the diagnostic performance of US for AC. A systematic review was conducted following PRISMA guidelines. We meticulously screened articles from MEDLINE, Embase, and the Cochrane Library, spanning from inception to August 2023. We employed the search strategy combining the keywords "bedside US", "emergency US" or "point-of-care US" with "AC". Two reviewers independently screened the titles and abstracts of the retrieved articles to identify suitable studies. The inclusion criteria encompassed articles investigating the diagnostic performance of US for AC. Data regarding diagnostic performance, sonographers, and sonographic findings including the presence of gallstone, gallbladder (GB) wall thickness, peri-GB fluid, or sonographic Murphy sign were extracted, and a meta-analysis was executed. Case reports, editorials, and review articles were excluded, as well as studies focused on acalculous cholecystitis. The study quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Forty studies with 8,652 patients were included. The majority of studies had a low risk of bias and applicability concerns. US had a pooled sensitivity of 71% (95% CI, 69–72%), a specificity of 85% (95% CI, 84–86%), and an accuracy of 0.83 (95% CI, 0.82–0.83) for the diagnosis of AC. The pooled sensitivity and specificity were 71% (95% CI, 67–74%) and 92% (95% CI, 90–93%) performed by emergency physicians (EPs), 79% (95% CI, 71–85%) and 76% (95% CI, 69–81%) performed by surgeons, and 68% (95% CI 66–71%) and 87% (95% CI, 86–88%) performed by radiologists, respectively. There were no statistically significant differences among the three groups. US is a good imaging modality for the diagnosis of AC. EP-performed US has a similar diagnostic performance to radiologist-performed US. Further investigations would be needed to investigate the impact of US on expediting the management process and improving patient-centered outcomes.

中文翻译：

---

超声对急性胆囊炎的诊断性能：系统评价和荟萃分析


超声（US）诊断急性胆囊炎（AC）的最新概述仍然缺乏。本系统评价旨在评估超声对 AC 的诊断性能。根据 PRISMA 指南进行了系统审查。我们精心筛选了 MEDLINE、Embase 和 Cochrane 图书馆的文章，时间跨度从成立到 2023 年 8 月。我们采用了将关键词“床边美国”、“紧急美国”或“床旁美国”与“AC”相结合的搜索策略。 ”。两名评审员独立筛选检索到的文章的标题和摘要，以确定合适的研究。纳入标准包括调查美国 AC 诊断性能的文章。提取有关诊断表现、超声检查人员和超声检查结果的数据，包括是否存在胆结石、胆囊 (GB) 壁厚度、GB 周围液体或超声墨菲征，并进行荟萃分析。病例报告、社论和评论文章以及针对非结石性胆囊炎的研究被排除在外。研究质量通过诊断准确性研究质量评估-2 (QUADAS-2) 工具进行评估。纳入了 40 项研究，涉及 8,652 名患者。大多数研究的偏倚风险和适用性问题都较低。 US 的汇总敏感性为 71%（95% CI，69–72%），特异性为 85%（95% CI，84–86%），准确度为 0.83（95% CI，0.82–0.83）。 AC 的诊断。由急诊医生 (EP) 进行的汇总敏感性和特异性分别为 71% (95% CI, 67–74%) 和 92% (95% CI, 90–93%)、79% (95% CI, 71–85%) ）和 76%（95% CI，69-81%）由外科医生执行，68%（95% CI，66-71%）和 87%（95% CI，86-88%）由放射科医生执行。 三组间无统计学差异。超声是诊断 AC 的良好成像方式。 EP 执行的 US 与放射科医生执行的 US 具有相似的诊断性能。需要进一步调查来调查美国对加快管理流程和改善以患者为中心的结果的影响。