Sonographic evaluation of gallbladder wall thickening: Analysis of specific patterns

The US scans of 51 patients with gallbladder wall thickening were reviewed and sonographic features were correlated with findings on surgical and clinical follow-up. Nineteen patients (37%) had intrinsic gallbladder disease, including 13 with acute cholecystitis (ACC). Thirty-two patients (63%) had other abnormalities, including 19 with hypoalbuminemia. Two distinct patterns of gallbladder wall thickening were noted. In 8 of 13 (62%) patients with ACC, but none of the others, irregular, discontinuous, lucent, echogenic intramural bands were seen, while in 11 of 38 (29%) without ACC but only one of 13 (8%) with ACC smooth, circumferential lucent zone interposed between two relatively uniform echogenic layers was seen. Other abnormalities, including intramural echogenic foci and wall irregularities, were more frequent in patients with ACC but were not specific. Utilization of these features may prove helpful in suggesting or excluding a diagnosis of ACC in patients in whom the cause of gallbladder wall thickening is not apparent