Department of Ultrasound, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Department of Biliary and Pancreatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
J Gastroenterol Hepatol. 2018 Jun;33(6):1295-1299. doi: 10.1111/jgh.14080. Epub 2018 Mar 9.
Polypoid lesions of the gallbladder may be neoplastic or non-neoplastic. Correct diagnosis would help reduce unnecessary cholecystectomies. This study aimed to determine the predictive value of individual ultrasound characteristics for diagnosis of neoplastic polyps and to build a scoring system based on these characteristics.
A total of 109 patients with gallbladder polyps ≥ 6 mm underwent conventional ultrasound examination and received finally diagnosis by pathological examination. All images were analyzed to determine characteristics of the lesions. Univariate and multivariate analyses were used to identify the predictors of neoplastic polyps, and a scoring system was built based on multivariate analysis.
Maximum diameter, height/width ratio, base width, presence of hyper-echoic spots, and intralesional blood flow were statistically significant (P = 0.011, P = 0.016, P = 0.003, P = 0.031, and P = 0.022, respectively) predictors of neoplastic lesions. The total score = (Maximum diameter, ≥ 13.9 mm = 1, < 13.9 = 0) + (Base width, ≥ 3.5 mm = 1, < 3.4 = 0) + (Height/width ratio, ≤ 1.05 = 1, > 1.05 = 0) + (Hyper-echoic spots, presence = 0, absence = 1) + (Blood flow, presence = 1, absence = 0). Receiver operating characteristic curve showed that the sensitivity, specificity, and accuracy for the risk of neoplastic polyps with scores of 3 or higher were 81.6%, 86.7%, and 84.4%, respectively.
This ultrasound-based scoring system could be a useful means for differentiating between neoplastic and non-neoplastic gallbladder polyps in the clinic.
胆囊息肉样病变可能是肿瘤性或非肿瘤性的。正确的诊断有助于减少不必要的胆囊切除术。本研究旨在确定单个超声特征对诊断肿瘤性息肉的预测价值，并建立基于这些特征的评分系统。
共 109 例胆囊息肉≥6mm 的患者接受了常规超声检查，并通过病理检查最终诊断。对所有图像进行分析，以确定病变的特征。使用单因素和多因素分析来确定肿瘤性息肉的预测因素，并基于多因素分析建立评分系统。
最大直径、高度/宽度比、基底宽度、存在高回声点和内部血流在统计学上是肿瘤性病变的显著预测因素（P=0.011、P=0.016、P=0.003、P=0.031 和 P=0.022）。总评分=（最大直径，≥13.9mm=1，<13.9mm=0）+（基底宽度，≥3.5mm=1，<3.4mm=0）+（高度/宽度比，≤1.05=1，>1.05=0）+（高回声点，存在=0，不存在=1）+（血流，存在=1，不存在=0）。受试者工作特征曲线显示，评分≥3 时诊断肿瘤性息肉的敏感性、特异性和准确性分别为 81.6%、86.7%和 84.4%。
该基于超声的评分系统可为临床鉴别肿瘤性和非肿瘤性胆囊息肉提供有用手段。
