旨在评估双能计算机断层扫描 (DECT) 在区分非急性良性与恶性胆囊壁增厚 (GBWT) 方面的性能。这项前瞻性研究包括接受动脉晚期 (LAP) 和门静脉期 (PVP) 的连续 GBWT 成人) 2022 年 1 月至 2023 年 5 月期间进行的 DECT。最终诊断基于组织病理学或 3-6 个月的随访影像学。 LAP 和 PVP 中的 DECT 图像由两名放射科医生独立评估。比较两组之间的人口统计学、定性和定量参数。进行多变量logistic回归以确定上述因素与恶性GBWT之间的关联。纳入75名患者（平均年龄56±12.8岁，46名女性）。 42 名患者为良性 GBWT，33 名患者为恶性 GBWT。在整个组中，女性（p = 0.018）、淋巴结肿大（p = 0.011）和大网膜结节（p = 0.044）与恶性GBWT显着相关。整个组中良性和恶性 GBWT 的 DECT 特征均无显着差异。在黄色肉芽肿性胆囊炎 (XGC, n = 9) 与胆囊癌 (GBC) (n = 33) 亚组中，140 keV LAP VMI 的平均衰减值与恶性 GBWT 显着相关 [p = 0.023，曲线下面积 0.759 (95 %CI 0.599-0.919)]。DECT 生成的定量参数在区分非急性良性和恶性 GBWT 方面没有增加价值。然而，在选定的患者亚组中，DECT 可能有助于区分 XGC 和 GBC。此外，可能需要更大规模的研究来证实这些发现。对于怀疑患有黄色肉芽肿性胆囊炎 (XGC) 的非急性胆囊壁增厚患者，DECT 结果可能有助于将 XGC 与壁增厚型胆囊癌区分开来。 CT 诊断良性和恶性胆囊壁增厚 (GBWT) 具有挑战性。定量双能 CT (DECT) 特征在区分良性和恶性 GBWT 方面没有提供额外价值。 DECT 可能有助于部分患者区分黄色肉芽肿性胆囊炎和胆囊癌。© 2024。作者获得欧洲放射学会独家许可。

To evaluate the performance of dual-energy computed tomography (DECT) in differentiating non-acute benign from malignant gallbladder wall thickening (GBWT).This prospective study comprised consecutive adults with GBWT who underwent late arterial phase (LAP) and portal venous phase (PVP) DECT between January 2022 and May 2023. The final diagnosis was based on histopathology or 3-6 months follow-up imaging. DECT images in LAP and PVP were assessed independently by two radiologists. The demographic, qualitative, and quantitative parameters were compared between two groups Multivariate logistic regression was performed to determine the association between the aforementioned factors and malignant GBWT.Seventy-five patients (mean age 56 ± 12.8 years, 46 females) were included. Forty-two patients had benign, and 33 had malignant GBWT. In the overall group, female gender (p = 0.018), lymphadenopathy (p = 0.011), and omental nodules (p = 0.044) were significantly associated with malignant GBWT. None of the DECT features differed significantly between benign and malignant GBWT in overall group. In the xanthogranulomatous cholecystitis (XGC, n = 9) vs. gallbladder cancer (GBC) (n = 33) subgroup, mean attenuation value at 140 keV LAP VMI was significantly associated with malignant GBWT [p = 0.023, area under curve 0.759 (95%CI 0.599-0.919)].DECT-generated quantitative parameters do not add value in differentiating non-acute benign from malignant GBWT. However, DECT may have a role in differentiating XGC from GBC in a selected subgroup of patients. Further, larger studies may be necessary to confirm these findings.In patients with non-acute gallbladder wall thickening in whom there is suspicion of xanthogranulomatous cholecystitis (XGC), DECT findings may allow differentiation of XGC from wall thickening type of gallbladder cancer.Differentiation of benign and malignant gallbladder wall thickening (GBWT) at CT is challenging. Quantitative dual energy CT (DECT) features do not provide additional value in differentiating benign and malignant GBWT. DECT may be helpful in a subgroup of patients to differentiate xanthogranulomatous cholecystitis from gallbladder cancer.© 2024. The Author(s), under exclusive licence to European Society of Radiology.