Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China.
World J Gastroenterol. 2018 Feb 14;24(6):744-751. doi: 10.3748/wjg.v24.i6.744.
To describe contrast-enhanced ultrasound (CEUS) features and evaluate differential diagnosis value of CEUS and conventional ultrasound for patients with benign and malignant gallbladder lesions.
This study included 105 gallbladder lesions. Before surgical resection and pathological examination, conventional ultrasound and CEUS were performed to examine for lesions. Then, all the lesions were diagnosed as (1) benign, (2) probably benign, (3) probably malignant or (4) malignant using both conventional ultrasound and CEUS. The CEUS features of these gallbladder lesions were analyzed and diagnostic efficiency between conventional ultrasound and CEUS was compared.
There were total 17 cases of gallbladder cancer and 88 cases of benign lesion. Some gallbladder lesions had typical characteristics on CEUS (., gallbladder adenomyomatosis had typical characteristics of small nonenhanced areas on CEUS). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CEUS were 94.1%, 95.5%, 80.0%, 98.8% and 95.2%, respectively. These were significantly higher than conventional ultrasound (82.4%, 89.8%, 60.9%, 96.3% and 88.6%, respectively). CEUS had an accuracy of 100% for gallbladder sludge and CEUS helped in differential diagnosis among gallbladder polyps, gallbladder adenoma and gallbladder cancer.
CEUS may provide more useful information and improve the diagnosis efficiency for the diagnosis of gallbladder lesions than conventional ultrasound.
描述胆囊良恶性病变的超声造影(CEUS)特征,并评估 CEUS 和常规超声对胆囊良恶性病变的鉴别诊断价值。
本研究纳入 105 个胆囊病变。在手术切除和病理检查前,对所有病变均行常规超声和 CEUS 检查。然后,根据常规超声和 CEUS 检查结果,将所有病变分为(1)良性,(2)可能良性,(3)可能恶性或(4)恶性。分析这些胆囊病变的 CEUS 特征,并比较常规超声和 CEUS 的诊断效率。
共 17 例胆囊癌,88 例良性病变。部分胆囊病变在 CEUS 上具有典型特征(如胆囊腺肌症在 CEUS 上表现为小的无增强区)。CEUS 的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 94.1%、95.5%、80.0%、98.8%和 95.2%,均显著高于常规超声(82.4%、89.8%、60.9%、96.3%和 88.6%)。CEUS 对胆囊泥沙样结石的诊断准确率为 100%,有助于胆囊息肉、胆囊腺瘤和胆囊癌的鉴别诊断。
CEUS 可为胆囊病变的诊断提供更多有用信息,提高诊断效率,优于常规超声。