Abstract | OBJECTIVES: The purpose of this study is to evaluate the diagnostic performance of HRUS, CT, and MRI for differentiating xanthogranulomatous cholecystitis (XGC) from gallbladder (GB) cancer. MATERIALS AND METHODS: Patients with surgically proven XGC (n = 40) and GB cancer (n = 44), who had undergone at least one HRUS (n = 43), CT (n = 82), or MRI (n = 34) examination between 2000 and 2012, were included. Two radiologists retrospectively graded the likelihood of XGC or GB cancer using a 5-point confidence scale; they also assessed the imaging features. Statistical analyses were performed using ROC, ANOVA, and Fisher's exact test. RESULTS: Diagnostic performance of MRI was better than HRUS for differentiating XGC from GB cancer (AUCs = 0.867 and 0.911 vs. AUCs = 0.818 and 0.86). However, HRUS showed a better performance than CT (AUCs = 0.818 and 0.86 vs. AUCs = 0.806 and 0.84) with moderate to excellent agreement (κ = 0.48-0.83). Statistically common findings for XGC included non-focal thickening, smooth GB wall, presence of intramural nodules, type I enhancement of wall, transient hepatic attenuation difference, and continuity of mucosa (p < 0.05). Co-existence of gallstones (OR = 16.5), non-focal thickening (OR = 14.7), and collapsed lumen (OR = 13.0) on HRUS, and type I enhancement on CT (OR = 3.52) were independently associated with XGC (p < 0.05). CONCLUSION: Although MRI showed a better performance than both HRUS and CT, HRUS showed a better performance than CT. The co-existence of gallstones, non-focal thickening, and collapsed lumen on HRUS was independently associated with XGC.
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Authors | Eun Sun Lee, Jung Hoon Kim, Ijin Joo, Jae Young Lee, Joon Koo Han, Byung Ihn Choi |
Journal | Abdominal imaging
(Abdom Imaging)
Vol. 40
Issue 7
Pg. 2281-92
(Oct 2015)
ISSN: 1432-0509 [Electronic] United States |
PMID | 25952571
(Publication Type: Journal Article)
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Analysis of Variance
- Cholecystitis
(diagnosis)
- Cholecystography
- Diagnosis, Differential
- Female
- Gallbladder
(diagnostic imaging, pathology)
- Gallbladder Neoplasms
(diagnosis)
- Granuloma
(diagnosis)
- Humans
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Preoperative Care
- ROC Curve
- Reproducibility of Results
- Retrospective Studies
- Tomography, X-Ray Computed
- Ultrasonography, Doppler
- Xanthomatosis
(diagnosis)
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