Incidentally Detected Focal Fundal Gallbladder Wall Thickening at Contrast-Enhanced Computed Tomography: Prevalence and Computed Tomography Features of Malignancy

J Comput Assist Tomogr. 2019 Jan/Feb;43(1):149-154. doi: 10.1097/RCT.0000000000000802.

Abstract

Objective: The aim of this study was to determine the prevalence and computed tomography (CT) features of malignancy in incidental focal fundal gallbladder wall thickening.

Methods: Patients with incidental focal fundal gallbladder wall thickening on CT were included if they had an ultrasound or magnetic resonance imaging diagnostic of the etiology (n = 19), stability on CT for 1 year (n = 84), or pathological correlation (n = 13). Morphologies were classified as type 1 (nodular/pinched intramural low attenuation), type 2 (intramural low attenuation), type 3 (homogeneous enhancement), type 4 (nodular/pinched homogeneous enhancement), type 5 (intramural cystic spaces), or type 6 (hyperenhancing/heterogeneous enhancement).

Results: One hundred sixteen patients had the following morphologies: type 1 (n = 57), type 2 (n = 10), type 3 (n = 6), type 4 (n = 19), type 5 (n = 14), and type 6 (n = 10). Four cases (3.4%; 95% confidence interval, 0.9%-8.6%) of malignancy were identified (type 6 in 3 and type 3 in 1).

Conclusions: Incidental focal fundal gallbladder wall thickening is usually benign. Computed tomography features help distinguish benign from malignant etiologies.

MeSH terms

  • Contrast Media*
  • Diagnosis, Differential
  • Female
  • Gallbladder / diagnostic imaging
  • Gallbladder / pathology
  • Gallbladder Neoplasms / diagnostic imaging*
  • Gallbladder Neoplasms / pathology
  • Humans
  • Image Enhancement / methods*
  • Incidental Findings*
  • Male
  • Middle Aged
  • Prevalence
  • Radiographic Image Enhancement / methods*
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media