American Journal of Roentgenology, Vol 162, 1105-1108, Copyright © 1994 by American Roentgen Ray Society
Diagnosis of acute cholecystitis with color Doppler sonography: significance of arterial flow in thickened gallbladder wall
EK Paulson, MA Kliewer, BS Hertzberg, SS Paine and BA Carroll
Department of Radiology, Duke University Medical Center, Durham, NC 27710.
OBJECTIVE. Thickening of the gallbladder wall is a common though
nonspecific sonographic finding. The purpose of this study was to determine
if color Doppler sonography shows arterial flow in thickened gallbladder
walls more frequently in patients with cholecystitis than in patients with
other causes of thickening of the wall. SUBJECTS AND METHODS. Seventy-six
patients with thickened gallbladder walls (> or = 3 mm) were
prospectively examined with color Doppler sonography. When arteries were
detected, Doppler waveforms were used to determine resistive indexes. The
final diagnosis was based on pathologic reports, results of percutaneous
cholecystostomy, and clinical records. RESULTS. Of the 23 patients (30%)
with cholecystitis (11 acute, 12 chronic), nine (39%) had arterial flow and
14 (61%) had no arterial flow. Of the 53 patients (70%) without
cholecystitis, 20 (38%) had arterial flow and 33 (62%) had no arterial flow
(p = 1.00). The mean resistive indexes (+/- 1 SD) for patients with and
without cholecystitis were 60% +/- 13% and 65% +/- 9%, respectively (p =
0.33). No significant difference 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 nonspecific and of limited value in the diagnosis of
cholecystitis.
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