Abstract
Background
Our objective is to study the gallbladder abnormalities on MR images associated with carcinoma of the pancreatic head.
Methods
Thirty-six patients who had surgical resection of pancreatic head carcinoma were retrospectively analyzed regarding the appearance of the tumor and gallbladder on MR imaging performed within one month before surgery. The changes of the gallbladder wall, and the dimension of the gallbladder, cystic duct, pericholecystic region, and common bile duct (CBD) on MR imaging were noted.
Results
About 92% (33/36) of patients had at least one gallbladder abnormality on MR imaging, including thickened gallbladder wall (58%), gallbladder wall striation (19%), gallbladder wall severe enhancement (44%), enlarged gallbladder (33%), gallbladder stone (19%), dilatation of cystic duct (67%), focally increased liver parenchymal enhancement adjacent to the gallbladder (19%), and pericholecystic fluid (11%). 64% of patients had dilated CBD. The diameter of the cystic duct was correlated with those of the CBD (r = 0.45, P < 0.01) and gallbladder (r = 0.56, P < 0.0001). Enlarged gallbladder, dilatation of the cystic duct, and CBD were correlated with chronic cholecystitis.
Conclusion
Most patients with pancreatic head carcinoma show gallbladder abnormalities on MR imaging. Cystic duct dilatation follows CBD dilatation and is the primary cause for dilated gallbladder and chronic cholecystitis in carcinoma of pancreatic head.
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References
Flamm CR, Mark DH, Aronson N (2002) Evidence-based assessment of ERCP approaches to managing pancreaticobiliary malignancies. Gastrointest Endosc 56(6 Suppl):S218–S225
Chitkara YK (1995) Pathology of the gallbladder in gallstone pancreatitis. Arch Pathol Lab Med 119(4):355–359
Chitkara YK (1993) Pathology of the gallbladder in common bile duct obstruction: the concept of ascending cholecystitis. Hum Pathol 24(3):279–283
Hamade AM, Al-Bahrani AZ, Owera AM, et al. (2005) Therapeutic, prophylactic, and preresection applications of laparoscopic gastric and biliary bypass for patients with periampullary malignancy. Surg Endosc 19(10):1333–1340
Rappaport MD, Villalba M (1990) A comparison of cholecysto- and choledochoenterostomy for obstructing pancreatic cancer. Am Surg 56(7):433–435
Elsayes KM, Oliveira EP, Narra VR, et al. (2007) Magnetic resonance imaging of the gallbladder: spectrum of abnormalities. Acta Radiol 48(5):476–482
Pamuklar E, Semelka RC (2005) MR imaging of the pancreas. Magn Reson Imaging Clin N Am 13(2):313–330
Bennett GL, Rusinek H, Lisi V et al. (2002) CT findings in acute gangrenous cholecystitis. AJR Am J Roentgenol 178(2):275–281
Jung SE, Lee JM, Lee K et al. (2005) Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern. Eur Radiol 15(4):694–701
Altun E, Semelka RC, Elias J Jr et al. (2007) Acute cholecystitis: MR findings and differentiation from chronic cholecystitis. Radiology 244(1):174–183
Maalouf EF, Fagbemi A, Duggan PJ et al. (2000) Magnetic resonance imaging of intestinal necrosis in preterm infants. Pediatrics 105(3 Pt 1):510–514
Boland GW, Slater G, Lu DS, et al. (2000) Prevalence and significance of gallbladder abnormalities seen on sonography in intensive care unit patients. AJR Am J Roentgenol 174(4):973–977
Castelain M, Grimaldi C, Harris AG et al. (1993) Relationship between cystic duct diameter and the presence of cholelithiasis. Dig Dis Sci 38(12):2220–2224
Yamashita K, Jin MJ, Hirose Y et al. (1995) CT finding of transient focal increased attenuation of the liver adjacent to the gallbladder in acute cholecystitis. AJR Am J Roentgenol 164(2):343–346
Songür Y, Temuçin G, Sahin B (2001) Endoscopic ultrasonography in the evaluation of dilated common bile duct. J Clin Gastroenterol 33(4):302–305
Grand D, Horton KM, Fishman EK (2004) CT of the gallbladder: spectrum of disease. Am J Roentgenol 183(1):163–170
Oikarinen H (2006) Diagnostic imaging of carcinomas of the gallbladder and the bile ducts. Acta Radiol 47(4):345–358
Low VH (1997) Retrograde cholangiography of malignant biliary strictures: spectrum of appearances and pitfalls. Abdom Imaging 22(4):421–425
Sherlock S, Dooley J (1997) Jaundice. In: Sherlock S, Dooley J (eds) Diseases of the liver and biliary system. London, Blackwell, pp 201–216
Konno K, Ishida H, Sato M et al. (2003) Dilatation of the cystic duct in patients with obstructive jaundice. Abdom Imaging 28(1):75–78
Fiske CE, Laing FC, Brown TW (1980) Ultrasonographic evidence of gallbladder wall thickening in association with hypoalbuminemia. Radiology 135(3):713–716
Ralls PW, Quinn MF, Juttner HU et al. (1981) Gallbladder wall thickening: patients without intrinsic gallbladder disease. AJR Am J Roentgenol 137(1):65–68
Wegener M, Börsch G, Schneider J, et al. (1987) Gallbladder wall thickening: a frequent finding in various nonbiliary disorders–a prospective ultrasonographic study. J Clin Ultrasound 15(5):307–312
Kim MY, Baik SK, Choi YJ et al. (2003) Endoscopic sonographic evaluation of the thickened gallbladder wall in patients with acute hepatitis. J Clin Ultrasound 31(5):245–249
Loud PA, Semelka RC, Kettritz U, et al. (1996) MRI of acute cholecystitis: comparison with the normal gallbladder and other entities. Magn Reson Imaging 14(4):349–355
Demachi H, Matsui O, Hoshiba K et al. (1997) Dynamic MRI using a surface coil in chronic cholecystitis and gallbladder carcinoma: radiologic and histopathologic correlation. J Comput Assist Tomogr 21(4):643–651
Acknowledgments
Dr. Zhang XM was supported by Grant 30370436 and 30770612, National nature science foundation of China, and Grant NCET-06-0820, Ministry of Education of P.R. China
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Zhang, X.M., Mitchell, D.G., Byun, J.H. et al. Gallbladder abnormalities in carcinoma of pancreatic head: findings on MR imaging. Abdom Imaging 34, 507–513 (2009). https://doi.org/10.1007/s00261-008-9422-6
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DOI: https://doi.org/10.1007/s00261-008-9422-6