Evaluation of CT in the diagnosis of xanthogranulomatous cholecystitis
SHEN Xun-ze1, WU Jin-xiu2, ZHOU He-shan3, ZHANG Guang-qiang2, YANG Bin3
1. Department of Radiology, Shaoxing People’s Hospital, Shaoxing Zhejiang 312000, China;2. Department of Radiology, Second Affiliated Hospital of Medical College, Zhejiang University, Hangzhou 310009, China;3. Department of Radiology, First People’s Hospital of Hangzhou City, Hangzhou 310000, China
Abstract：Objective: To access the value of CT in the diagnosis of xanthogranulomatous cholecystitis(XGC) and its differentiation from thick-wall gallbladder carcinoma. Methods: The maximum thickness of the cystic wall was measured in 13 cases of XGC and 19 cases of thick-wall gallbladder carcinoma. The following CT features were analyzed and recorded:①intramural hypoattenuated nodules or bands of the gallbladder; ②mucosal line; ③appearances of the cystic inner wall; ④infiltration of the liver; ⑤dilation of intrahepatic bile duct; ⑥retroperitoneal lymphadenopathy. Results: The mean thickness of the cystic wall for XGC was (24.7±16.0)mm and (18.3±8.6)mm for gallbladder carcinoma. Intramural hypoattenuated nodules were seen in 10 patients with XGC and 6 with gallbladder carcinoma. Mucosal line was observed in 8 patients with XGC and 6 with gallbladder carcinoma. Inner wall of the gallbladder was even in 8 patients with XGC and 8 with gallbladder carcinoma. Hepatic involvement was seen in 5 patients with XGC and 7 with gallbladder carcinoma. Expansion of intrahepatic bile ducts existed in 1 patient with XGC but in 12 with gallbladder carcinoma. Retroperitoneal lymphadenopathy was observed in 4 patients with gallbladder carcinoma but none with XGC. Conclusion: Intramural hypoattenuated nodules or bands in thickened cystic wall without dilation of intrahepatic bile duct is the most valuable CT features for diagnosis of XGC and its’ differentiation from gallbladder carcinoma.
2007, Vol. 18 
