Browse

Analysis of enhancement pattern of flat gallbladder wall thickening on MDCT to differentiate gallbladder cancer from cholecystitis

Cited 55 time in Web of Science Cited 63 time in Scopus
Authors
Kim, Soo Jin; Lee, Jeong Min; Lee, Jae Young; Kim, Se Hyung; Han, Joon Koo; Choi, Byung Ihn; Choi, Jin Young
Issue Date
2008-08-22
Publisher
American Roentgen Ray Society
Citation
AJR Am J Roentgenol. 2008 ;191(3):765-71.
Keywords
AdultAgedAged, 80 and overCholecystitis/*radiographyCholecystography/*methodsDiagnosis, DifferentialFemaleGallbladder Neoplasms/*radiographyHumansMaleMiddle AgedRadiographic Image Enhancement/*methodsReproducibility of ResultsSensitivity and SpecificityTomography, X-Ray Computed/*methods
Abstract
OBJECTIVE: The objective of our study was to determine the diagnostic value of analyzing the pattern of gallbladder wall enhancement on MDCT to characterize diffuse gallbladder wall thickening as benign or malignant. MATERIALS AND METHODS: MDCT scans obtained during the portal venous phase in 78 patients with gallbladder wall thickening caused by various pathologic conditions were retrospectively reviewed by two blinded observers. The CT features of benign and malignant gallbladder wall thickening were compared by means of univariate and multivariate analyses. The study cases were then divided into five patterns according to enhancement pattern. Using these five patterns, two radiologists reviewed the MDCT images and recorded their diagnostic confidence for differentiating benign versus malignant cause on a 5-point scale. The diagnostic performance of CT was evaluated by each observer using a receiver operating characteristic curve analysis. RESULTS: The thicknesses of the inner and outer layers ("thick" enhancing inner layer > or = 2.6 mm, "thin" outer layer < or = 3.4 mm), strong enhancement of the inner wall, and irregular contour of the affected wall were significant predictors for a malignant cause of gallbladder wall thickening (p < 0.001). The two-layer pattern with a strongly enhancing thick inner layer and weakly enhancing or nonenhancing outer layer and the one-layer pattern with a heterogeneously enhancing thick layer were patterns that were significantly associated with gallbladder cancer (p < 0.05). When we consider those two enhancing patterns as a sign of malignancy, the diagnostic accuracy of MDCT was 89.1% and 87.6% for the two observers, respectively. CONCLUSION: Analyzing the enhancement pattern of a thickened gallbladder wall on MDCT is helpful in differentiating gallbladder cancer from benign inflammatory diseases.
ISSN
1546-3141 (Electronic)
0361-803X (Print)
Language
English
URI
http://www.ajronline.org/cgi/reprint/191/3/765.pdf

https://hdl.handle.net/10371/62410
DOI
https://doi.org/10.2214/AJR.07.3331
Files in This Item:
There are no files associated with this item.
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Radiology (영상의학전공)Journal Papers (저널논문_영상의학전공)
  • mendeley

Items in S-Space are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse