肝炎伴胆囊壁慢性增厚

History

32-year-old man with chronic hepatitis C and recent elevation of liver enzyme levels

32岁男性，慢性丙肝，肝功能检查肝酶升高。

Fig 3.4.1：

Fig 3.4.2：

Imaging Findings

Axial SSFSE (Figure 3.4.1) and fat-suppressed SSFP (Figure 3.4.2) images demonstrate marked diffuse thickening of the gallbladder wall.

横断位SSFSE(Figure 3.4.1)及脂肪抑制SSFP(Figure 3.4.2)示胆囊壁弥漫性均匀增厚。

Diagnosis

Hepatitis with marked gallbladder wall thickening

肝炎伴胆囊壁慢性增厚

Comment

Gallbladder wall thickening is associated with a large number of pathologic conditions, including cirrhosis, acute and chronic cholecystitis, ascites, hypoalbuminemia, viral hepatitis, chronic renal failure, and heartfailure. The physiologic mechanism responsible for diffuse gallbladder thickening in the presence of systemic or diffuse hepatic disease is uncertain but probably is related to elevated portal venous pressure or decreased intravascular osmotic pressure, or both.

胆囊壁增厚可能与很多病变有关。如肝硬化、急慢性胆囊炎、腹水、低蛋白血症、病毒性肝炎、慢性肾衰、心衰等。全身病变或肝脏弥漫性病变伴胆囊壁增厚的生理机制尚不完全明确，可能与门静脉压力增高、或血管内渗透压降低有关，也可能是两者共同作用而来。

The main point to remember is that a thickened gallbladder doesn’t always mean cholecystitis, even in patients with right upper quadrantpain (a frequent symptom in patients with cirrhosis and hepatitis).

胆囊壁增厚往往并不是胆囊炎，甚至患者临床表现为右上腹痛也是如此（肝硬化和肝炎也常表现为右上腹痛）。