The role of diffusion-weighted examination in non-polyploid gallbladder malignancies: A preliminary study

The aim of the present study was to investigate the diagnostic value of diffusion-weighted magnetic resonance imaging in gallbladder malignancies, which are typically diagnosed during surgery because the radiologic findings are similar to those of cholecystitis-caused diffuse thickening of the gallbladder wall.

Seven patients with gallbladder malignancies and nine patients with benign gallbladder pathology were included in this study. In one of the patients with a malignancy, a lesion was determined on the porcelain gallbladder; in another patient, acute myeloblastic leukemia had infiltrated the gallbladder, causing the diffuse wall thickening. Five subjects had a primary malignant gallbladder. The view of the bladder wall was evaluated visually in increasing b values. Apparent diffusion coefficient measurements were obtained from at least three sites of the bladder wall in each patient, and the results of the measurements were analyzed after comparing the malignant and benign groups. In the malignant group, the results of the radiological outcomes were compared with histological examinations. In the benign group, cholecystitis was diagnosed by observing normalization of the bladder wall thickening via surgery or medical treatment.

There was a statistically significant difference in apparent diffusion coefficient levels between the malignant group, which caused diffuse thickening of the gallbladder wall, and the benign group (Student t test, p<0.01).

According to this preliminary study, observation of distinct brightness of the gallbladder wall in diffusion-weighted examination with a high b value is a significant finding in terms of diffuse gallbladder malignancy. A value below the 0.86 mm 2 /sn cut-off was significant for malignancy in apparent diffusion coefficient mapping.