Ek. Paulson et al., DIAGNOSIS OF ACUTE CHOLECYSTITIS WITH COLOR DOPPLER SONOGRAPHY - SIGNIFICANCE OF ARTERIAL FLOW IN THICKENED GALLBLADDER WALL, American journal of roentgenology, 162(5), 1994, pp. 1105-1108
OBJECTIVE. Thickening of the gallbladder wall is a common though nonsp
ecific sonographic finding. The purpose of this study was to determine
if color Doppler sonography shows arterial flow in thickened gallblad
der walls more frequently in patients with cholecystitis than in patie
nts with other causes of thickening of the wall. SUBJECTS AND METHODS.
Seventy-six patients with thickened gallbladder walls (greater than o
r equal to 3 mm) were prospectively examined with color Doppler sonogr
aphy. When arteries were detected, Doppler waveforms were used to dete
rmine resistive indexes. The final diagnosis was based on pathologic r
eports, results of percutaneous cholecystostomy, and clinical records.
RESULTS. Of the 23 patients (30%) with cholecystitis (11 acute, 12 ch
ronic), nine (39%) had arterial flow and 14 (61%) had no arterial flow
. Of the 53 patients (70%) without cholecystitis, 20 (38%) had arteria
l flow and 33 (62%) had no arterial flow (p = 1.00). The mean resistiv
e indexes (+/- 1 SD) for patients with and without cholecystitis were
60%+/-13% and 65%+/-9%, respectively (p = 0.33). No significant differ
ence in the detection of arterial flow was found between patients with
acute cholecystitis and those with chronic cholecystitis. CONCLUSION.
The presence of arterial flow in the thickened gallbladder wall is no
nspecific and of limited value in the diagnosis of cholecystitis.