Gallbladder wall thickening: Exploring the role of elastography

Background Gallbladder wall thickening (GBWT) can arise from benign conditions such as simple edema due to ascites, hypoalbuminemia, hepatitis, or right heart failure, or from more concerning causes such as inflammation (e.g., cholecystitis) or neoplastic processes (e.g., polyps or carcinoma). Differentiating between these etiologies can be clinically challenging. This study aimed to evaluate the diagnostic performance of shear wave elastography (SWE) in distinguishing between edematous GBWT (E-GBWT) and non-edematous GBWT (NE-GBWT) based on tissue stiffness measurements.

Methods This observational study included 32 patients diagnosed with GBWT on abdominal ultrasound (US) between January and November 2024. SWE examinations were standardized, involving 10 repeated measurements of the thickened GB wall. Mean SWE velocities (MSV) were calculated and analyzed using receiver operating characteristic (ROC) analysis to identify potential cut-off values for differentiating E-GBWT from NE-GBWT.

Results The cohort consisted predominantly of males (29 patients), with ascites present in 18 cases. The mean GB wall thickness was 8.9±4.7 mm. Of the total, 18 patients had E-GBWT, while 14 had NE-GBWT. After adjusting for age, the MSV in the E-GBWT group (1.73±0.47 m/s) was significantly lower than that in the NE-GBWT group (2.18±0.53 m/s; p=0.04). A cut-off value of 1.92 m/s yielded a sensitivity of 78.6% and a specificity of 72.2% for diagnosing NE-GBWT, with an area under the curve (AUC) of 0.734 (95% confidence interval: 0.547–0.921).

Conclusion Shear wave elastography (SWE) shows promise as a non-invasive diagnostic tool for differentiating simple edematous from non-edematous GBWT. Its ability to provide quantitative stiffness measurements may aid clinicians in refining etiological evaluations and guiding management decisions.

 

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Publication History

Article published online:
16 October 2025