Utility of sonographic gallbladder wall patterns in differentiating malignant from cirrhotic ascites

Thirty-one patients with ascites associated with malignancy and 49 patients with cirrhotic ascites were enrolled in a sonographic study of the gallbladder wall. Three gallbladder wall patterns were recognized: A, single-layered, nonthickened wall; B, single-layered, thickened wall; and C, double-layered, thickened wall. Pattern A was found more frequently in patients with malignant ascites, while patterns B and C were detected more frequently in patients with cirrhotic ascites. If "nonthickened gallbladder wall" is used as a criterion for prediction of malignant ascites, the sensitivity is 80.6% and the specificity 93.9%. This suggests that sonographic examination of the gallbladder wall is useful in the differentiation of malignant from cirrhotic ascites.