Expanded gallbladder fossa: Simple MR imaging sign of cirrhosis

PURPOSE: To determine the frequency on magnetic resonance (MR) images of a widened pericholecystic space, which the authors call the expanded gallblad der fossa sign, and to assess the sensitivity and specificity of this sign for cirrhosis. MATERIALS ANP METHODS: Three-hundred thirteen patients who underwent MR ima ging were included in this study, including 190 with pathologically proved cirrhosis (cirrhosis patients) and 123 without history of chronic liver dis eases (control subjects). MR images were qualitatively; evaluated by three independent observers for the presence of the expanded gallbladder fossa si gn. This sign was considered present if there was enlargement of the perich olecystic space (ie, gallbladder fossa) and the space was bounded laterally by the edge of the right hepatic lobe and medially by the edge of the left lateral segment,in conjunction with nonvisualization of the left medial se gment. RESULTS: The expanded gallbladder fossa sign was seen in 129 cirrhosis pati ents and in three control subjects (P < .001). The sensitivity, specificity , accuracy, and positive predictive value of this sign for the MR diagnosis of cirrhosis were 68%, 98% 80%, and 98%, respectively. CONCLUSION: The,expanded gallbladder fossa sign on MR images is a frequentl y present, specific Indicator of cirrhosis:This sign can be used as a simpl e and highly specific sign of cirrhosis, if present, despite the overall se nsitivity of 68%.