Vialle R, Velasco S, Milin S, Bricot V, Richer J-P, Levillain P-M, Tasu J-P
Service de radiologie, CHU de Poitiers, BP 577, 86021 Poitiers, France.
Gastroenterol Clin Biol. 2008 Nov;32(11):931-41. doi: 10.1016/j.gcb.2008.09.009. Epub 2008 Oct 26.
Most of gallbladder tumors are benign. Adenoma, cholesterol polyps, or adenomyomatosis are most frequently typical on ultrasonographic images. All symptomatic lesions must be considered as indications for surgery. It may be difficult to identify precancerous or malignant lesion. Polyps over 1cm are indication for preventive cholecystectomy. In case of suspicious polyp or suspicious wall thickening, endoscopic ultrasonography can be helpful to evaluate local tumoral spread and eliminate differential diagnosis. Unfortunately, diagnosis of gallbladder cancer is often late, when surgical resection can't be curative. Computed tomography and magnetic resonance imaging examinations are then useful for local and metastatic staging.
大多数胆囊肿瘤是良性的。腺瘤、胆固醇息肉或腺肌增生症在超声图像上最为常见。所有有症状的病变都必须被视为手术指征。可能难以识别癌前病变或恶性病变。直径超过1厘米的息肉是预防性胆囊切除术的指征。对于可疑息肉或可疑的胆囊壁增厚，内镜超声有助于评估肿瘤的局部扩散并排除鉴别诊断。不幸的是，胆囊癌的诊断往往较晚，此时手术切除无法治愈。计算机断层扫描和磁共振成像检查对于局部和转移分期很有用。
