Chronological change of gallbladder fossa nodularity in the liver as observed in patients with alcoholic liver disease: cross-sectional and longitudinal observation.

Abstract

Purpose: To confirm the concept that gallbladder fossa nodularity (GBFN) as observe in patients with alcoholic liver disease (ALD) develops in a biphasic fashion as the cirrhotic process progresses, by clarifying the sequential or chronological change of GBFN both in cross-sectional and longitudinal analyses.

Materials and methods: We retrospectively recruited 52 ALD patients who had both quadruple phase CT and gadoxetate-enhanced MRI (EOB-MRI) within 6 months between 2013 and 2020, and GBFN were morphologically classified into grades 0-3, as previously described. As a cross-sectional study, correlation coefficients (rho values) between mALBI grades and GBFN grades were compared for monophasic vs biphasic models. Biphasic models were defined based on the median values of liver stiffness as measured by MR elastography and extracellular volume fraction as calculated from CT data. Similar analysis was done for GBFN signal intensity on hepatobiliary phase of EOB-MRI (HBP-SI). As a longitudinal study, we recruited patients for whom at least 3-year follow-up of GBFN were available using any CT or MR imaging examination.

Results: As for cross-sectional study, the rho values for the biphasic model were significantly larger than those for the monophasic model, both for GBFN grades and HBP-SI (p < 0.01). As for the longitudinal study, 10 patients were available, 6 of whom showed downgrading of GBFN as the cirrhotic change progressed.

Conclusion: Our cross sectional and longitudinal analyses suggested GBFN would develop in a biphasic pattern both on morphology and HBP-SI as the cirrhotic process progresses.