Jee Young Son, Presenter: Nothing to Disclose

Young Jun Kim MD, Abstract Co-Author: Nothing to Disclose

Hee Sun Park MD, Abstract Co-Author: Nothing to Disclose

Sung Min Ko, Abstract Co-Author: Nothing to Disclose

Sung Il Jung MD, Abstract Co-Author: Nothing to Disclose

Hae Jeong Jeon MD, Abstract Co-Author: Nothing to Disclose

Although gallbladder wall edema (GBWE) is one of well-known extrahepatic CT findings of liver cirrhosis, its clinical significance has been sparsely investigated. The purpose of this study was to retrospectively evaluate a) which clinical features affect the presence of GBWE in cirrhotic patients, and b) whether degree of GBWE is associated with such clinical findings.

For a 12-month period, 412 patients with liver cirrhosis underwent quadruple-phasic liver protocol MDCT. Of them, patients with diseases or conditions potentially altering gallbladder wall thickness were excluded: acute or chronic cholecystitis (n=4), previous treatment for HCC (n=123), abdominal surgery (n=28), abdominal inflammatory diseases (n=4). A total of 253 patients were enrolled in this study. CT images were reviewed by two radiologists in consensus with regard to presence or absence of GBWE. GBWE was defined as diffuse thickening (> 3 mm) of subserosal layer in the gallbladder. For cases with GBWE, thickness of subserosal layer was measured. Clinical features including Child-Pugh score, etiology of liver cirrhosis, complete blood count, and liver function test were obtained in all patients. Univariate and multivariate analysis were performed to evaluate correlation between presence and degree of GBWE and clinical features.

Of 253 patients, 75 (30%) had GBWE. GBWE was seen 17% (35/204) of patients with Child-Pugh class A, 78% (32/41) of Child-Pugh class B, and 100% (8/8) of Child-Pugh class C (p < 0.001). Univariate analysis revealed lower values of hemoglobin, platelet, and albumin, higher values of total bilirubin and AST, alcoholic etiology, presence of gallstone, and presence of ascites were significantly associated with presence of GBWE. Multivariate analysis indicated only three factors, albumin, platelet count, and ascites, were significantly correlated with presence of GBWE. However, thickness of gallbladder wall edema was not correlated with any of clinical features.

The presence of ascites, lower platelet and lower albumin level are explanatory factors for the presence of GBWE. However, degree of GBWE is not related with such clinical factors.

Presence of GBWE in cirrhotic patients on CT suggests advanced stage of liver cirrhosis represented by lower albumin, lower platelet, and presence of ascites.

Son, J, Kim, Y, Park, H, Ko, S, Jung, S, Jeon, H, MDCT of Gallbladder Wall Edema in Patients with Liver Cirrhosis: Correlation with Clinical Features.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8010877.html