What the thickening of the gallbladder wall hides: findings in imaging studies and etiology

Congress:

ECR 2019

Poster Number:

C-2346

Type:

Educational Exhibit

Keywords:

Pathology, Diagnostic procedure, Ultrasound, MR, CT, Abdomen

Authors:

C. Martínez Martínez¹, J. A. Miras Ventura², P. Pérez Naranjo¹, L. Guirado Isla¹, F. Briones Bajaña¹, M. Fernández Conesa¹, L. Díaz Rubia¹, I. Garrido Márquez¹; ¹Granada/ES, ²Granada, Granada/ES

DOI:

10.26044/ecr2019/C-2346

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-2346

Table 1: Causes of thickening of the gallbladder wall.

Fig. 1: Gallbladder hydrops with parietal thickening and biliary sludge and...

Fig. 2: Gallbladder hydrops with increased of parietal thickness up to 8 mm,...

Fig. 3: Gallbladder with cholelithiasis and slightly thickening of the wall but without...

Learning objectives

Knowing the pathologies that cause wall thickening of the gallbladder and its radiographic features. Identifying the signs in the imaging studies that indicate gallbladder wall thickening. Addressing the differential diagnosis of the wall thickening of the gallbladder based on the findings in imaging studies.

Background

It is considered that the gallbladder wall is thickened when it measures more than 3 mm. Ultrasound, CT and MRI allow direct visualization of the gallbladder wall. Ultrasound has traditionally been the initial test to assess the gallbladder wall due to its easy availability and high sensitivity to detect biliary pathology such as lithiasis. In ultrasound, the thickening of the gallbladder wall is detected as several lines of different echogenicity. In some cases, CT is the test of choice to find parietal thickening of the...

Findings and procedure details

The thickening of the vesicular wall can occur in both primary and secondary diseases. The first group includes cholecystitis (acute, chronic, acalculous and xanthogranulomatous), carcinoma of the gallbladder and adenomyomatosis, while in the second pathologies such as liver cirrhosis, hepatitis, right heart failure, renal failure and pancreatitis among others. Physiological thickening of the vesicular wall should not be confused with a pathological finding in patients who gallbladder is not distended. For this reason, in order to correctly assess the parietal thickening of the gallbladder it...

Conclusion

The thickening of the gallbladder wall can be caused by numerous pathologies, including primary diseases of the gallbladder, as well as secondary pathologies usually caused by systemic diseases. The differential diagnosis is important because in some pathologies such as cholecystitis the treatment is surgical. However, the findings in imaging studies are not pathognomonic and in many cases these findings must be correlated with clinical data.

Personal information

References

Gore RM, Yaghmai V, Newmark GM, Berlin JW, Miller FH. Imaging of benign and malignant disease of the gallbladder. Radiol Clin N Am 2002; 40:1307-1323. Boland GWL, Slater G, Lu DSK, Eisenberg P, Lee MJ, Mueller PR. Prevalence and significance of gallbladder abnormalities seen on sonography in intensive care unit patients. AJR 2000; 174:973-977. Gallbladder - Wall Thickening [Internet]. The Radiology Assistant. [cited 2019 Jan 3]. Available from: http://www.radiologyassistant.nl/en/p43a0746accc5d/gallbladder-wall-thickening.html