Sonographic and colour doppler morphology in carcinoma gallbladder

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Conventional radiography has diagnostic limitations for gallbladder cancer (GBC).
• Ultrasonography (USG) offers improved diagnostic accuracy for GBC compared to radiography, particularly for advanced stages.
• Colour Doppler USG (CD-USG) provides additional hemodynamic information that may enhance GBC detection.

Purpose of the Study:

• To evaluate the morphological and flow characteristics of gallbladder cancer using conventional USG and CD-USG.
• To determine the diagnostic utility of combining USG and CD-USG for GBC identification.
• To correlate imaging findings with clinical presentation and pathological outcomes.

Main Methods:

• A study involving 100 patients with suspected GBC, utilizing conventional USG to assess mass morphology and associated features.
• Sixty of these patients underwent CD-USG to evaluate intralesional/perilesional vascularity, peak systolic flow velocity (Vmax), resistive index (RI), and pulsatility index (PI).
• Patients were categorized into Group-I (gallbladder with mass lesion) and Group-II (mass in gallbladder fossa).

Main Results:

• USG identified gallbladder mass lesions in 44% of cases (Group-I) and masses in the gallbladder fossa in 56% (Group-II).
• Associated findings included calculi (73%), liver infiltration (74%), intrahepatic ductal dilatation (52%), lymphadenopathy (19%), and ascites (5%).
• CD-USG detected vascularity in 78.3% of cases, predominantly pulsatile flow (91.3% in Group-I). Mean Vmax and PI were higher in Group-I.

Conclusions:

• The presence of calculi in 73% of cases indicates a strong association between gallstones and GBC.
• The combined use of USG and CD-USG significantly improves the detection rate of gallbladder cancer.
• CD-USG's ability to visualize vascularity is crucial for enhancing GBC diagnosis when integrated with conventional USG.