Article type: Research Article
Authors: Zheng, Shu-Guang; | Xu, Hui-Xiong; | Liu, Lin-Na | Lu, Ming-De | Xie, Xiao-Yan | Wang, Wen-Ping | Hu, Bing | Yan, Kun | Ding, Hong | Tang, Shao-Shan | Qian, Lin-Xue | Luo, Bao-Ming
Affiliations: Department of Medical Ultrasound, Tenth People's Hospital of Tongji University, Shanghai Tenth People's Hospital, Shanghai, China | Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China | Department of Ultrasound, Zhongshan Hospital of Fudan University, Shanghai, China | Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai, China | Department of Ultrasound, Peking University School of Oncology, Beijing Cancer Institute, Beijing, China | Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China | Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China | Department of Ultrasound, Second Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
Note: [] Corresponding author: Hui-Xiong Xu, MD, PhD, Department of Medical Ultrasound, Tenth People's Hospital of Tongji University, Shanghai Tenth People's Hospital, Shanghai, China. Tel.: +86 21 66301031; E-mail: xuhuixiong@hotmail.com
Note: [] Corresponding author: Ming-De Lu, MD, DMSc, Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. Tel.: +86 20 87765183; E-mail: lumd@live.com
Abstract: OBJECTIVE: To assess the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of polypoid lesions of gallbladder (PLGs). METHODS: CEUS was performed to 116 patients (mean age, 49.6 years; range, 21–80 years) with PLGs from 8 university hospitals. 9 cases of biliary sludge were proven by surgery and the remaining 107 cases were confirmed by histopathological examination. The confidence level, diagnostic performance, inter-observer agreement of two independent readers with different experience was assessed. The readers were blind to the imaging and clinical results of the patients. RESULTS: There were significant differences between benign and malignant PLGs in patient age, gender, lesion size, echogenicity, stalk, time-to-peak, vascularity on CEUS, enhancement pattern, and wall destruction. The confidence levels increased significantly and the interobserver agreement increased from 0.425 to 0.601 after CEUS. The sensitivity increased from 22.2 to 77.8% after CEUS in the staff radiologist, and from 22.2 to 66.7% in the resident radiologist. The correctly characterized lesions were 64.7% before versus 87.1% after CEUS (P = 0.125) for the staff radiologist, and 57.8% versus 70.7% for the resident radiologist (P = 0.007). No significance was found in the subgroup of lesions ≤1.0 cm before and after CEUS for the two radiologists. CONCLUSIONS: CEUS using convex multifrequency probes could detect the dynamic microvascularization of PLGs greater than 1.0 cm and facilitate the differentiation between benign and malignant tumors.
Keywords: Contrast-enhanced ultrasound, gallbladder, polypoid lesion, differential diagnosis
DOI: 10.3233/CH-121651
Journal: Clinical Hemorheology and Microcirculation, vol. 55, no. 3, pp. 359-374, 2013
