Abstract: Objective To investigate the imaging features of xanthogranulomatous cholecystitis. Methods A retrospective analysis was conducted on 48 cases of pathologically confirmed xanthogranulomatous cholecystitis diagnosed and treated at the Fifth Medical Center of PLA General Hospital from July 2010 to July 2022. Their imaging features were analyzed and compared with surgical pathology findings. Results Among the cases, 42 (87.5%) exhibited wall-thickening type, 1 (2.08%) showed mass-forming type, and 5 (10.42%) presented intraluminal type. Diffuse wall thickening was observed in 36 cases (75%), intramural nodules in 31 cases (64.6%), intact mucosal line in 33 cases (68.8%), transient hepatic parenchymal enhancement in the arterial phase in 19 cases (39.6%), adjacent liver infiltration in 2 cases (4.2%), and gallbladder stones in 37 cases (77.1%). Intrahepatic bile duct dilation was noted in 10 cases (20.8%), and liver abscess occurred in 1 case (2.08%). Conclusion CT and MRI findings of xanthogranulomatous cholecystitis show characteristic features. Proficient mastery of its imaging features can significantly improve the accuracy of preoperative differential diagnosis between it and gallbladder cancer, providing a basis for clinical surgery.

Key words: Xanthogranuloma cholecystitis, Gallbladder cancer, CT, Magnetic resonance imaging