Gallbladder carcinoma and chronic cholecystitis: differentiation with two-phase spiral CT

AbdominalImaging Springer-Verlag New York, Inc. 2003

Received: 18 May 2002 / Revision accepted: 11 June 2003 / Published online: 28 October 2003

Abdom Imaging (2004) 29:102108DOI: 10.1007/s00261-003-0080-4Gallbladder carcinoma and chronic

cholecystitis: differentiation with two-phase

spiral CTE. J. Yun,1,2 S. G. Cho,1 S. Park,1 S.-W. Park,1 W.-H. Kim,1 H.-J. Kim,1 C. H. Suh11Department of Radiology, Inha University College of Medicine, Inha University Hospital, 7-206 3rd Street, Shinheung-dong, Choonggu, Incheon, 400-711, Korea2Department of Radiology, Hanllym University College of Medicine, Kangdong Sacred Heart Hospital, 445, Gil-dong, Kangdong-gu,

Seoul, 134-701, KoreaAbstractThe objective of the present study was to determine whether

an analysis of two-phase spiral computed tomographic (CT)

features provides a sound basis for the differential diagnosis

between gallbladder carcinoma and chronic cholecystitis.

Eighty-two patients, 35 with gallbladder carcinoma and 47

with chronic cholecystitis, underwent two-phase spiral CT.

We reviewed the two-phase spiral CT features of thickness

and enhancement pattern of the gallbladder wall seen during

the arterial and venous phases. Mean wall thicknesses were12.6 mm in the gallbladder carcinoma group and 6.9 mm in

the chronic cholecystitis group. The common enhancement

patterns seen in gallbladder carcinoma were (a) a highly

enhanced thick inner wall layer during the arterial phase that

showed isoattenuation with the adjacent hepatic parenchyma

during the venous phase (16 of 35, 45.7%) and (b) a highly

enhanced thick inner wall layer during both phases (eight of

35, 22.9%). The most common enhancement pattern of

chronic cholecystitis was isoattenuation of the thin inner

wall layer during both phases (42 of 47, 89.4%). In conclusion, awareness of the wall thickening and enhancement

patterns in gallbladder carcinoma and chronic cholecystitis

on two-phase spiral CT appears to be valuable in differentiating these two different disease entities.Key words: Gallbladder, computed tomographyGallbladder, neoplasmCholecystitisDifferentiation between gallbladder carcinoma and chronic

cholecystitis has been an important clinical issue because the

procedures involved in the prognosis and management of

gallbladder carcinoma and cholecystitis differ. Because the

clinical manifestations of gallbladder carcinoma are nonspecic and often indistinguishable from those of chronic cholecystitis, the accurate preoperative diagnosis of gallbladder

carcinoma is difcult. Thus, it is important that the radiologist be able to differentiate gallbladder carcinoma from

chronic cholecystitis [17]. Despite the efforts of many

previous investigators [8, 9], early diagnosis of gallbladder

carcinoma and differentiation between malignancy...