Diagnosis of acute cholecystitis with color Doppler sonography: significance of arterial flow in thickened gallbladder wall.

OBJECTIVE. Thickening of the gallbladder wall is a common though nonspecific sonographic finding. The purpose of this study was to determine if color Doppler sonography shows arterial flow in thickened gallbladder walls more frequently in patients with cholecystitis than in patients with other causes of thickening of the wall. SUBJECTS AND METHODS. Seventy-six patients with thickened gallbladder walls (greater than or equal to 3 mm) were prospectively examined with color Doppler sonography. When arteries were detected, Doppler waveforms were used to determine resistive indexes. The final diagnosis was based on pathologic reports, results of percutaneous cholecystostomy, and clinical records. RESULTS. Of the 23 patients (30%) with cholecystitis (11 acute, 12 chronic), nine (39%) had arterial flow and 14 (61%) had no arterial flow. Of the 53 patients (70%) without cholecystitis, 20 (38%) had arterial flow and 33 (62%) had no arterial flow (p = 1.00). The mean resistive indexes (+/- 1 SD) for patients with and without cholecystitis were 60%+/-13% and 65%+/-9%, respectively (p = 0.33). No significant difference in the detection of arterial flow was found between patients with acute cholecystitis and those with chronic cholecystitis. CONCLUSION. The presence of arterial flow in the thickened gallbladder wall is nonspecific and of limited value in the diagnosis of cholecystitis.