Significance of a gallbladder wall blood flow analysis by Doppler ultrasonography in the diagnosis of gallbladder cancer

Abstract

We reviewed the maximal blood flow velocity (Vmax) in the gallbladder wall (cystic artery) using Doppler ultrasonography in 46 patients (cancer N=14, benign N=32). The Vmax of cancer (45.0±13.2 cm/s) was significantly higher than that observed for chronic cholecystitis, polyps or ADM (adenomyomatosis) (p<0.01). An ROC analysis showed a Vmax cut-off value of 35.2 cm/s, while the sensitivity was 85.7% and the specificity was 88.2%. The histological findings clarified the fibrous hyperplastic change in the intraarterial membrane of the basal area lying under the cancer nest. This alteration was not found in the non-cancer areas, polyps or ADM. These results suggested that stenotic change of the artery may cause an increase in the blood flow velocity. In conclusion, a blood flow analysis makes it possible to directly evaluate cancerous changes in the preoperative examination.