Application of multi-detector-row CT in differential diagnosis of cholecystitis and gallbladder abnormal changes caused by liver parenchymal diseases

doi:10.3877/cma.j.issn.2095-3232.2017.06.018

Abstract

Abstract:

Objective

To investigate the application value of multi-detector-row CT (MDCT) in differential diagnosis of cholecystitis and gallbladder abnormal changes caused by liver parenchymal diseases.

Methods

Clinical data of 84 patients with gallbladder abnormal changes detected by MDCT enhancement examination in Hainan Provincial Nongken General Hospital between November 2014 and October 2015 were analyzed retrospectively. The informed consents of all patients were obtained and the local ethical committee approval was received. All patients were divided into cholecystitis group and liver disease group according to the CT diagnostic results. There were 32 patients in cholecystitis group, 16 males and 16 females, with an average age of (46±3) years old, and 52 in liver disease group, 33 males and 19 females, with an average age of (47±2) years old. All patients were examined by MDCT and confirmed by operative pathology or other imaging findings, and the difference of MDCT features was observed and compared between cholecystitis and gallbladder abnormal changes caused by liver parenchymal diseases. Thickness of cyst wall in both groups was compared by t test and the rate was compared by Chi-square test or Fisher's exact test.

Results

Thickness of cyst wall in cholecystitis group was (4.5±0.5) mm, which was significantly longer than (3.7±0.4) mm in liver disease group (t=9.010, P<0.05). Enhancement rate of cyst wall, bile density increase rate and transient enhancement rate of adjacent liver tissues in cholecystitis group was respectively 100%, 31% and 19%, significantly higher than 75%, 6% and 0 in liver disease group (χ²=9.465, 9.832, -; P<0.05). The incidence of fuzzy contour gallbladder and gallbladder surrounding effusion was respectively 91% and 9% in cholecystitis group, while 75% and 29% in liver disease group, significant differences were observed between two groups (χ²=34.125, 4.461; P<0.05). The gallbladder effusion was observed generally distributing on one side in cholecystitis group, while mostly distributing around the gallbladder without flowing in liver disease group.

Conclusions

MDCT can help to differentiate cholecystitis from gallbladder abnormal changes caused by liver parenchymal diseases.

Key words: Tomography, spiral computed, Cholecystitis, Liver cirrhosis, Hepatitis, chronic, Carcinoma, hepatocellular, Diagnosis, differential

Wencai Tang, Jinghui Huang, Chuanzi Li, Zhongshi Nie, Suihuang Wang. Application of multi-detector-row CT in differential diagnosis of cholecystitis and gallbladder abnormal changes caused by liver parenchymal diseases[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2017, 06(06): 499-503.

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References 20

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组别	例数	囊壁厚径（mm，±s）	囊壁强化（例）		胆囊轮廓模糊（例）		胆汁密度升高（例）		邻近肝组织一过性强化（例）		胆囊周围积液（例）
组别	例数	囊壁厚径（mm，±s）	无	有	无	有	无	有	无	有	无	有
胆囊炎组	32	4.5±0.5	00	32	03	29	22	10	26	6	29	03
肝病组	52	3.7±0.4	13	39	39	13	49	03	00	0	37	15
统计值	?	t=9.010	χ²=9.465		χ²=34.125		χ²=9.832		-		χ²=4.461
P值	?	<0.001	0.002		<0.001		0.002		0.001		0.035

组别	例数	囊壁厚径（mm，±s）	囊壁强化（例）		胆囊轮廓模糊（例）		胆汁密度升高（例）		邻近肝组织一过性强化（例）		胆囊周围积液（例）
组别	例数	囊壁厚径（mm，±s）	无	有	无	有	无	有	无	有	无	有
胆囊炎组	32	4.5±0.5	00	32	03	29	22	10	26	6	29	03
肝病组	52	3.7±0.4	13	39	39	13	49	03	00	0	37	15
统计值	?	t=9.010	χ²=9.465		χ²=34.125		χ²=9.832		-		χ²=4.461
P值	?	<0.001	0.002		<0.001		0.002		0.001		0.035

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