Meena Anamika, Kumari Madhuri, Anand Rama, Solanki R S, Nair Nikhil, Pathania O P, Nangia Anita, Prasad Surya N
Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna, IND.
Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, IND.
Cureus. 2024 Aug 20;16(8):e67266. doi: 10.7759/cureus.67266. eCollection 2024 Aug.
This study aimed to explore the correlation between morphological patterns and multidetector computed tomography (MDCT) enhancement patterns in gallbladder cancer with locoregional infiltration among the Indian population.
This cross-sectional study was conducted across the pathology, surgery, and radiodiagnosis departments at Lady Hardinge Medical College, New Delhi. It focused on patients diagnosed with gallbladder disorders during the study period, identified through clinical examination or MDCT. Each patient underwent a fasting computed tomography (CT) scan using a Philips Brilliance 40-slice MDCT scanner. A neutral oral contrast, consisting of 1200 ml of water and 300 ml of 20% w/v mannitol, was administered. Additionally, for two patients suspected of gallbladder perforation extending to the pyloric duodenal area, a 2% non-ionic water-soluble contrast agent was used.
The study found no statistically significant association between intraluminal polypoidal growth and other infiltration sites. However, wall thickening was significantly associated with various infiltration sites, including the liver, colon, bile ducts, and vascular structures. A strong positive correlation was observed between portovenous hyperenhancement and all examined morphological patterns, with the most notable correlations found with non-contrast CT (NCCT) hypo-isoenhancement. Conversely, arterial hyperenhancement showed an inverse relationship with some morphological patterns, with correlation coefficients of -0.60 for intraluminal polypoidal growth versus gallbladder wall thickening and mass replacement of the gallbladder versus intraluminal polypoidal growth.
Gallbladder cancer frequently leads to the replacement or damage of the gallbladder, with both focal and diffuse wall thickening being common findings. Hypo-isoenhancement was the most prevalent imaging pattern, while hyperenhancement was less common. Although intraluminal polypoidal growth did not significantly correlate with metastasis, wall thickening was significantly associated. These results emphasize the importance of specific imaging patterns in assessing the severity of gallbladder cancer and informing treatment strategies.
本研究旨在探讨印度人群中胆囊癌伴局部浸润的形态学模式与多排螺旋计算机断层扫描（MDCT）增强模式之间的相关性。
本横断面研究在新德里哈丁夫人医学院的病理科、外科和放射诊断科进行。研究对象为在研究期间经临床检查或MDCT确诊为胆囊疾病的患者。每位患者使用飞利浦Brilliance 40排MDCT扫描仪进行空腹计算机断层扫描（CT）。口服中性对比剂，其由1200毫升水和300毫升20%（重量/体积）甘露醇组成。此外，对于两名怀疑胆囊穿孔延伸至幽门十二指肠区域的患者，使用了2%的非离子型水溶性对比剂。
研究发现腔内息肉样生长与其他浸润部位之间无统计学显著关联。然而，胆囊壁增厚与包括肝脏、结肠、胆管和血管结构在内的各种浸润部位显著相关。门静脉期强化与所有检查的形态学模式之间观察到强正相关，与非增强CT（NCCT）低等强化的相关性最为显著。相反，动脉期强化与一些形态学模式呈负相关，腔内息肉样生长与胆囊壁增厚的相关系数为-0.60，胆囊肿块替代与腔内息肉样生长的相关系数为-0.60。
胆囊癌常导致胆囊被替代或破坏，局灶性和弥漫性壁增厚是常见表现。低等强化是最常见的影像学模式，而高强化较少见。虽然腔内息肉样生长与转移无显著相关性，但壁增厚与之显著相关。这些结果强调了特定影像学模式在评估胆囊癌严重程度和指导治疗策略方面的重要性。
