Journal of Diagnostics Concepts & Practice >
Application of contrast-enhanced ultrasound in diagnosis of gallbladder protrusion lesions
Received date: 2021-05-20
Online published: 2023-07-06
Gallbladder protrusion lesions(GPL) have two types:neoplastic lesions and non-neoplastic lesions. Neoplastic lesions include gallbladder adenoma and gallbladder carcinoma, while non-neoplastic lesions include cholesterol polyps, inflammatory polyps, gallbladder adenomyosis, etc. Conventional ultrasound examination is the preferred imaging examination for diagnosing GPL, however its diagnostic capacity is not satisfied. With the progress of medical technology, the value of contrast-enhanced ultrasound(CEUS) in the diagnosis of some GPL has been recognized. Different types of GPL present different degrees of enhancement, regression characteristics, enhancement modes, vascular architecture, and continuity of gallbladder wall in the arterial and venous phases of CEUS. Many studies at home and abroad believe that CEUS plays an important role in the diagnosis and differential diagnosis of GPL. When the contrast medium reaches its peak, the enhanced homogeneity of the lesions has the highest diagnostic efficiency in differentiating gallbladder adenoma from cholesterol polyps with diameter over 1 cm. Its sensitivity, specificity, positive predictive value, negative predictive value, accuracy and Youden’s J statistic are 100%, 90.9%, 92.9%, 100%, 95.8% and 0.91, respectively. The display rate of CEUS for the characteristic structure of gallbladder adenomyosis, the sinus, increases from 22.0% of conventional ultrasound to 56.1%.The sensitivity and specificity of CEUS in the diagnosis of gallbladder adenoma were 84.6% and 87.0%, respectively. CEUS has high sensitivity, specificity and negative predictive value in the diagnosis of xanthogranulomatous cholecystitis, which are 90%, 93% and 94% respectively.Irregular focus shape, dendritic vessels and low enhancement in venous phase are three specific signs of CEUS that suggests gallbladder adenocarcinoma. Combined with any two or three above signs, the specificity of CEUS for diagnosing gallbladder cancer may reach 92.4%. In the diagnosis of GPL,CUES may display certain characteristic manifestation and is worthy of clinical application.
FENG Meijing, REN Xinping . Application of contrast-enhanced ultrasound in diagnosis of gallbladder protrusion lesions[J]. Journal of Diagnostics Concepts & Practice, 2023 , 22(01) : 68 -74 . DOI: 10.16150/j.1671-2870.2023.01.011
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