Color Doppler sonography was used to clarify the origin and significance of the efferent flow signal from the gallbladder wall.
The efferent flow from the gallbladder wall was detected in 25 cases: 13 with acute cholecystitis, 1 with benign gallbladder
polyp, 1 with adenomyomatosis, 1 with gallbladder cancer, 5 with focal spared area in diffuse fatty liver, 3 with liver cirrhosis
(2 with hepatocellular carcinoma), and 1 with chronic hepatitis. The efferent flows communicated with the intrahepatic portal
branch (9 cases), the hepatic vein (2 cases), or both (1 case). Furthermore, regurgitating flow of intrahepatic portal branch
(P 5) was shown in 3 cases with acute cholecystitis. We conclude that the efferent flow from the gallbladder wall identified by
color Doppler sonography corresponded to the cystic vein, which is difficult to detect with other imaging modalities. Color
Doppler imaging may also be useful in assessing the severity of such pathologic conditions as acute cholecystitis or gallbladder
cancer, and also in clarifying the cause of the focal spared area found in diffuse fatty liver or cystic vein hypertension.