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Published on: September 22, 2023
Tumefactive Gallbladder Sludge at US: Prevalence and Clinical Importance
Mimi Kim1, Tae Wook Kang1, Kyung Mi Jang1
1From the Departments of Radiology (M.K., T.W.K., K.M.J., Y.K.K., S.H.K.), Pathology (S.Y.H.), and Internal Medicine (D.H.S.) and the Biostatics and Clinical Epidemiology Center (S.G.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-Dong, Gangnam-gu, Seoul 135-710, Republic of Korea.
Tumefactive sludge in the gallbladder is rare but can be malignant. Key risk factors for malignancy include older age, female sex, and lack of hyperechoic spots on ultrasound imaging.
Area of Science:
- Radiology
- Gastroenterology
- Oncology
Background:
- Gallbladder sludge is common, but tumefactive sludge is a rare variant.
- Distinguishing benign from malignant tumefactive sludge is clinically important.
Purpose of the Study:
- To determine the prevalence of tumefactive sludge on ultrasonography (US).
- To identify clinical and imaging differences between benign and malignant tumefactive sludge.
Main Methods:
- Retrospective analysis of 115,178 abdominal US exams from March 2001 to March 2015.
- Tumefactive sludge defined by specific US criteria (immovable, mass-like, no shadowing, no vascularity).
- Multivariate logistic regression used to identify risk factors for malignancy.
Main Results:
- Prevalence of tumefactive sludge was 0.1% (135/115,178).
- 14% (15/107) of tumefactive sludge cases were malignant.
- Risk factors for malignancy included older age, female sex, and absence of hyperechoic spots.
Conclusions:
- While rare, tumefactive gallbladder sludge has a significant malignancy rate.
- Close follow-up is crucial for patients with tumefactive sludge, particularly older women lacking hyperechoic spots.
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