Magnetic resonance imaging in guiding choice of treatment pathway in patients with cholecystolithiasis and diffuse inflammatory thickening of gallbladder wall
10.3760/cma.j.issn.1007-8118.2019.12.005
- VernacularTitle: 磁共振成像对胆囊结石伴胆囊壁弥漫性炎性增厚患者治疗选择的价值
- Author:
Kun YAN
1
;
Zhongxiang DING
2
;
Guoping CHEN
1
;
Jianjun ZHENG
1
;
Yinhua JIN
1
;
Bibo HU
1
;
Bin CHEN
1
;
Jingfeng ZHANG
3
Author Information
1. Department of Radiology, Ningbo Huamei Hospital, University of Chinese Academy of Sciences (Ningbo Second Hospital), Ningbo 315010, China
2. Department of Radiology, First People's Hospital of Hangzhou, Hangzhou 310006, China
3. Diagnostic and Therapeutic Center for Difficult and Complicated Disease, Ningbo Huamei Hospital, University of Chinese Academy of Sciences (Ningbo Second Hospital), Ningbo 315010, China
- Publication Type:Journal Article
- Keywords:
Cholecystolithiasis;
Clinical protocols;
Cholecystitis;
Hepatitis B;
Magnetic resonance imaging
- From:
Chinese Journal of Hepatobiliary Surgery
2019;25(12):899-904
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the use of conventional MR imaging to guide treatment in patients with cholecystolithiasis and diffuse inflammatory thickening of gallbladder wall.
Methods:The clinical data of patients who were treated in the Ningbo Huamei Hospital, University of the Chinese Academy of Sciences between January 2017 and January 2018 were analyzed. These patients were divided into two groups: patients with acute cholecystitis (n=139) and patients with viral hepatitis combined with cholecystolithiasis (n=67). Differences in the imaging signs in standardized upper abdominal contrast enhanced MRI examinations were retrospectively analyzed.
Results:The imaging signs, including stone location, continuity of gallbladder mucosa, exudation in peri-gallbladder space, edema of intrahepatic portal area showed significant differences between the two groups (all P<0.05). On stratification analysis, the type of thickened gallbladder wall, background of liver parenchyma and extent of edema in intrahepatic catchment area also showed significant differences (all P<0.05). The imaging signs, including non-gallbladder neck ductal stones, concentric thickening of gallbladder wall, continuous mucous membrane in gallbladder and no peri-gallbladder space exudation but diffuse edema of intrahepatic catchment area supported the diagnosis of viral hepatitis combined with gallstones. The imaging signs, including discontinuity of gallbladder mucosa, exudation of peri-gallbladder space, diffuse edema of gallbladder wall without a cirrhotic background and edema in intrahepatic portal area supported the diagnosis of acute calculous cholecystitis of gallbladder.
Conclusions:Routine upper abdominal contrast enhanced MRI plays an important role in demonstrating the underlying cause of gallbladder wall diffuse edema thickening in patients with gallstones. It provides an important reference for the choice of clinical treatment pathway.
