Sonographic diagnosis of unsuspected gallbladder cancer: imaging findings in comparison with benign gallbladder conditions.

Wibbenmeyer, Lucy; Sharafuddin, Melhem J.; Wolverson, Michael K.; Heiberg, Elisabeth; Wade, Terence P.; Shields, John B.

doi:10.2214/ajr.165.5.7572497

Cited by 73 publications

(49 citation statements)

References 5 publications

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“…The presence of a layered pattern of gallbladder wall on ultrasonography (striated appearance) has been associated with edematous non-malignant states [8,9]. On computed tomography, some studies [5,10] showed that the finding of disruption of the normal layers in a thickened gallbladder wall indicates malignancy.…”

Section: Discussionmentioning

confidence: 99%

Radiological evaluation of the enhancement patterns of thickened gallbladder wall to differentiate benign from malignancy

Kalra¹

2017

JGPLD

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commonly seen in women (two to three times) than in men and its incidence steadily increases with age [1]. Thickening of gallbladder wall is a commonly detected finding on different imaging modalities. The finding itself is however non-specific and can result from multiple pathologic conditions including surgical and non-surgical disorders. The least common presentation of gallbladder carcinoma is focal or diffuse thickening of the gallbladder wall, and is difficult to diagnose, particularly in the early stages. Considering the non-specific nature of the clinical manifestations, which are indistinguishable from chronic cholecystitis, it is important to have an imaging tool for early detection of gallbladder cancer, because the management and prognosis of gallbladder carcinoma differs from benign etiologies. It is also well recognized that early detection, although a mere coincidental rarity, improves survival [2][3][4]. On the other hand, misinterpretation of diffuse gallbladder wall thickening in patients who do not have primarily gallbladder disease can lead to unnecessary cholecystectomy. This situation calls for an improved imaging strategy to differentiate between benign and malignant causes of thickened gall bladder wall in order to select patients for aggressive therapeutic efforts [4].Computed tomography to differentiate cholecystitis from carcinoma has been evaluated as early as in 1984 [5], however the signs reported to be useful included detecting a focal mass, biliary obstruction at porta hepatis, invasion of liver and nodal metastases. Yun et al [6] evaluated different patterns of enhancement thickened gallbladder wall in arterial and venous phases and found them helpful in differentiating gallbladder carcinoma from chronic cholecystitis when using two-phase helical CT. The authors opined that two-phase spiral CT was more useful than single phase CT for differentiating between these two disease entities. Another retrospective study by Kim et al [7] aimed to differentiate the gallbladder Abstract Objective: To evaluate the enhancement patterns of thickened gallbladder wall on MDCT and vascularity of gallbladder wall on Doppler Ultrasound, and to correlate imaging findings with pathological diagnosis in malignant and non-malignant conditions. Methods:In this institute's ethics committee approved prospective study, 15 patients with gallbladder wall thickening (>3mm on ultrasonography) underwent contrast enhanced twophase MDCT of abdomen and Doppler examination for gallbladder. The gallbladder wall attenuation value on CT was measured by drawing Region of Interest and compared to liver parenchymal attenuation. Enhancement patterns of gallbladder wall on CT were analysed. The findings were correlated with pathological diagnosis. Results:The presence of layered pattern of enhancement of gallbladder wall was seen more in carcinoma (85.7%). Lack of layered pattern correlated with benign nature. The difference was statistically significant (p=0.005). The finding of hyper-attenuation of gallbladder wall to th...

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Section: Discussionmentioning

confidence: 99%

Radiological evaluation of the enhancement patterns of thickened gallbladder wall to differentiate benign from malignancy

Kalra¹

2017

JGPLD

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“…A polypoid mass was present in 27% and a GB replacing invasive mass was present in 50% of cases of GB cancer examined. 7 CT scan e reveals a mass obliterating the GB lumen in 42% of cases, a polypoidal mass in 26% and a diffuse wall thickening in 6% of cases. However, only one-third of pathologically positive nodes are identified preoperatively by CT-scan.…”

Section: Investigationsmentioning

confidence: 99%

Surgical management of carcinoma of gall bladder

Tyagi

2012

Medical Journal Armed Forces India

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“…Among the different diseases that cause gallbladder walls thickening besides acute cholecystitis, pancreatitis, diverticulitis, heart failure, pyelonephritis and hepatitis can be mentioned. The appropriate characterization and interpretation of such finding is of utmost importance, considering that the correct diagnosis has a direct impact on the treatment and that in some cases some of these diseases require surgical approach (2) . Ultrasonography is the initial imaging method for diagnostic approach and evaluation of the biliary system, as it is widely available, safe, innocuous and non-expen-…”

Section: Anatomy and Sonographic Techniquementioning

confidence: 99%

Espessamento parietal da vesícula biliar no exame ultrassonográfico: como interpretar?

et al. 2011

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The present review was aimed at providing help for correct interpretation of gallbladder wall thickening and differential diagnosis at ultrasonography. Gallbladder wall thickening is a frequent sonographic finding and has been subject of great interest for being considered as a hallmark feature of acute cholecystitis, despite the fact that such a finding is observed in a number of other medical conditions. An appropriate characterization and interpretation of this finding is of great importance, considering that the correct diagnosis has a direct impact on the treatment that in some cases includes surgery. In the present article, the authors describe a set of sonographic signs that, in association with clinical and laboratory findings can reduce the number of diagnostic hypotheses allowing a more accurate establishment of the cause for gallbladder wall thickening through a rational data evaluation. Keywords: Gallbladder; Ultrasonography; Inflammation; Neoplasm.O objetivo desta revisão é fornecer auxílio na interpretação correta do espessamento das paredes da vesícula biliar e seus possíveis diagnósticos diferenciais. O espessamento da vesícula biliar é um achado frequente em exame de ultrassonografia e um tema de grande interesse, por ter sido considerado durante muito tempo como sinal específico de colecistite aguda, apesar de se reconhecer que ocorre em uma série de outras situações clínicas. A adequada caracterização e interpretação desse achado é de grande importância, pois o diagnóstico correto tem impacto direto no tratamento, que em alguns casos inclui intervenção cirúrgica. Neste artigo procuramos apresentar um conjunto de sinais ultrassonográficos que, associados ao quadro clínico e laboratorial do paciente, permitem restringir as alternativas diagnósticas e estabelecer, com maior precisão, a causa do espessamento parietal da vesícula biliar, através de uma avaliação racional dos dados obtidos. Unitermos: Vesícula biliar; Ultrassonografia; Inflamação; Neoplasia. Abstract Resumo* Study developed at the

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Sonographic diagnosis of unsuspected gallbladder cancer: imaging findings in comparison with benign gallbladder conditions.

Cited by 73 publications

References 5 publications

Radiological evaluation of the enhancement patterns of thickened gallbladder wall to differentiate benign from malignancy

Radiological evaluation of the enhancement patterns of thickened gallbladder wall to differentiate benign from malignancy

Surgical management of carcinoma of gall bladder

Espessamento parietal da vesícula biliar no exame ultrassonográfico: como interpretar?

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