title: Expanded gallbladder fossa: simple MR imaging sign of cirrhosis.
abstract: OBJECTIVE
  To determine the frequency on magnetic resonance (MR) images of a widened pericholecystic space, which the authors call the expanded gallbladder fossa sign, and to assess the sensitivity and specificity of this sign for cirrhosis.
  
  
  METHODS
  Three-hundred thirteen patients who underwent MR imaging were included in this study, including 190 with pathologically proved cirrhosis (cirrhosis patients) and 123 without history of chronic liver diseases (control subjects). MR images were qualitatively evaluated by three independent observers for the presence of the expanded gallbladder fossa sign. This sign was considered present if there was enlargement of the pericholecystic space (i.e., gallbladder fossa) and the space was bounded laterally by the edge of the right hepatic lobe and medially by the edge of the left lateral segment, in conjunction with nonvisualization of the left medial segment.
  
  
  RESULTS
  The expanded gallbladder fossa sign was seen in 129 cirrhosis patients and in three control subjects (P < .001). The sensitivity, specificity, accuracy, and positive predictive value of this sign for the MR diagnosis of cirrhosis were 68%, 98%, 80%, and 98%, respectively.
  
  
  CONCLUSIONS
  The expanded gallbladder fossa sign on MR images is a frequently present, specific indicator of cirrhosis. This sign can be used as a simple and highly specific sign of cirrhosis, if present, despite the overall sensitivity of 68%.
authors.affiliation: Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
authors.forename: K
authors.initials: K
authors.lastname: Ito
authors.forename: D G
authors.initials: DG
authors.lastname: Mitchell
authors.forename: T
authors.initials: T
authors.lastname: Gabata
authors.forename: S M
authors.initials: SM
authors.lastname: Hussain
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005704:Gallbladder / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity