Pugliesi Rosa Alba, Siepmann Timo, Kaiser Daniel P O
University of Palermo, Palermo, Italy.
Division of Health Care Sciences Center for Clinical Research and Management Education Dresden, Dresden International University, Dresden, Germany.
Abdom Radiol (NY). 2025 Aug;50(8):3553-3559. doi: 10.1007/s00261-024-04756-0. Epub 2025 Feb 5.
Layering hyperintensity in the gallbladder is frequently observed on T1-weighted (T1w) magnetic resonance imaging (MRI), but its association with hepatobiliary disorders is not well understood.
This study aimed to evaluate the prevalence of T1w layering in the gallbladder and its correlation with ultrasound (US) findings and patient characteristics in a cohort with significant liver disease.
A single-center study from 2015 to 2022 included patients who underwent MRI and abdominal US within one week. Exclusion criteria were poor imaging quality and prior cholecystectomy. MRI findings were correlated with US and analyzed against patient characteristics.
Among 415 patients (mean age 58.3 ± 14.8 years; mean BMI 28.0 ± 4.5 kg/m²), 67% had abnormal liver function tests, with high prevalences of cirrhosis (n = 260), transjugular intrahepatic portosystemic shunt (TIPS) (n = 233), and choledocholithiasis (n = 106). T1w layering was observed in 56% (n = 232) and associated with higher BMI (p = 0.001) and with cholecystolithiasis (p < 0.001), but not with age, sex, or liver disease indicators. T1w layering was predictive of gallbladder sludge on US (odds ratio 17.2, 95% confidence interval 9.87-31.44, p < 0.001), with a sensitivity of 92.7% but moderate specificity (57.9%).
T1w layering on MRI strongly predicts gallbladder sludge detected on US and is associated with increased BMI in this cohort of patients with liver disease. However, the moderate specificity requires cautious interpretation, and our findings suggest that T1w layering may serve as a complementary diagnostic tool.
在T1加权（T1w）磁共振成像（MRI）上经常观察到胆囊内分层高信号，但对其与肝胆疾病的关联了解尚少。
本研究旨在评估在一组患有严重肝脏疾病的队列中，胆囊T1w分层的发生率及其与超声（US）检查结果和患者特征的相关性。
一项2015年至2022年的单中心研究纳入了在一周内接受MRI和腹部超声检查的患者。排除标准为成像质量差和既往有胆囊切除术史。将MRI检查结果与超声检查结果进行相关性分析，并根据患者特征进行分析。
在415例患者中（平均年龄58.3±14.8岁；平均体重指数28.0±4.5kg/m²），67%的患者肝功能检查异常，肝硬化（n=260）、经颈静脉肝内门体分流术（TIPS）（n=233）和胆总管结石（n=106）的发生率较高。56%（n=232）的患者观察到T1w分层，其与较高的体重指数（p=0.001）和胆囊结石（p<0.001）相关，但与年龄、性别或肝脏疾病指标无关。T1w分层可预测超声检查发现的胆囊胆汁淤积（优势比17.2，95%置信区间9.87-31.44，p<0.001），敏感性为92.7%，但特异性中等（57.9%）。
在这组肝病患者中，MRI上的T1w分层强烈预测超声检查发现的胆囊胆汁淤积，并与体重指数增加相关。然而，由于特异性中等，需要谨慎解读，我们的研究结果表明T1w分层可作为一种辅助诊断工具。
