Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern

Area of Science:

• Radiology
• Gastroenterology
• Pathology

Background:

• Gallbladder wall thickening is a common finding in various gallbladder diseases.
• Accurate diagnosis is crucial for appropriate patient management.
• Magnetic resonance (MR) imaging offers detailed visualization of gallbladder pathology.

Purpose of the Study:

• To correlate MR imaging findings of gallbladder wall thickening with histopathologic results.
• To evaluate the diagnostic value of MR imaging in differentiating gallbladder diseases based on wall layering patterns.
• To establish a classification system for MR-identified gallbladder wall thickening patterns.

Main Methods:

• Retrospective evaluation of HASTE sequence MR cholangiography images from 144 patients with gallbladder wall thickening.
• Classification of gallbladder wall thickening into four distinct layered patterns (Type 1-4) based on signal intensity and morphology.
• Correlation of MR imaging patterns with histopathologic diagnoses.

Main Results:

• A strong correlation was found between MR imaging layered patterns and histopathologic findings.
• Type 1 pattern correlated with chronic cholecystitis, Type 2 with acute cholecystitis, Type 3 with adenomyomatosis, and Type 4 with gallbladder carcinoma.
• All four patterns demonstrated high diagnostic performance: positive predictive value (PPV) ≥73%, sensitivity ≥92%, and specificity ≥95%.

Conclusions:

• MR imaging findings of gallbladder wall thickening, particularly the layered pattern, are characteristic of specific gallbladder diseases.
• The proposed classification system for layered patterns enhances the diagnostic value of MR imaging in gallbladder disease.
• MR imaging is a valuable tool for differentiating gallbladder pathologies based on wall thickening characteristics.