Differential diagnosis of gallbladder cancer

  X-rays are of little diagnostic value for this disease. Using the oral method of cholecystography, most patients present with a nonfunctional gallbladder. Barium meal of the upper gastrointestinal tract may show compression of the duodenal region of the gastric sinus, but this sign may also be seen in the acute inflammatory phase of the gallbladder. The following imaging tests are helpful for the diagnosis of this disease.  Ultrasound examination According to the current literature, among various imaging methods, ultrasound examination has the highest diagnostic rate of gallbladder cancer, with a confirmation rate of 62%~83%.  2.CT examination In previous years, the sensitivity of CT scan for gallbladder cancer diagnosis was low due to the influence of tumor size and contrast of surrounding organs. Recently, CT has been updated continuously, and the detection rate of gallbladder cancer by CT scan has been improved significantly. CT can observe the size and shape of gallbladder, especially the wall of gallbladder, and enhanced scan can show the thickness of gallbladder wall.  MRI is a new examination method applied in clinical practice in recent years, and its clarity of biliary system examination is significantly better than that of CT; it can better show various modes of spread of primary gallbladder cancer, especially the invasion of hepatoduodenal ligament and para-abdominal aorta by the tumor than CT and ultrasound. However, due to respiratory artifacts, partial volume effects, and the thin fat layer between the tumor and duodenum, the accuracy of MRI in showing duodenal invasion is very low and prone to error.  With the development of MRI water imaging technology, magnetic resonance cholangiopancreatography (MRCP) has been successfully applied in clinical practice, which can obtain three-dimensional images of the bile and pancreatic ducts and clearly display the biliary system inside and outside the liver.