Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan.
J Hepatobiliary Pancreat Sci. 2020 Dec;27(12):977-983. doi: 10.1002/jhbp.841. Epub 2020 Nov 6.
BACKGROUND/PURPOSE: The diagnosis of gallbladder (GB) lesions is occasionally difficult. Recently, superb microvascular imaging (SMI) of ultrasound has been developed as a novel microvascular imaging technique. We evaluated the feasibility of SMI for the diagnosis of GB lesions and compared microvascular imaging between benign and malignant GB lesions.
Twenty patients with GB-protruded lesions or wall thickening who underwent SMI from August 2015 to July 2017 were included in this retrospective study. The measured outcomes were the quality of microvascular imaging when compared between normal SMI (N-SMI) and contrast-enhanced SMI (CE-SMI), and the microvascular findings (vascularity, vascular morphology, presence of branching, and presence of caliber change) when compared between benign and malignant GB lesions.
The quality of microvascular imaging of CE-SMI was evaluated as better than that of N-SMI, showing a significant difference (P < .001). From the CE-SMI microvascular findings, the evaluation of vascular morphology and the presence of caliber change showed a significant difference between benign and malignant GB lesions (P = .005, P < .001).
The evaluation of GB lesions using SMI was feasible with a contrast agent. Vascular morphology and the presence of caliber change may help in the differential diagnosis of GB lesions.
背景/目的:胆囊(GB)病变的诊断偶尔较为困难。最近,超声超微血管成像(SMI)已被开发为一种新的微血管成像技术。我们评估了 SMI 诊断 GB 病变的可行性,并比较了良性和恶性 GB 病变的微血管成像。
本回顾性研究纳入了 2015 年 8 月至 2017 年 7 月间接受 SMI 的 20 例 GB 隆起性病变或壁增厚患者。测量的结果是正常 SMI(N-SMI)和对比增强 SMI(CE-SMI)之间的微血管成像质量,以及良性和恶性 GB 病变之间的微血管表现(血管生成、血管形态、分支存在和口径变化)。
CE-SMI 的微血管成像质量评价优于 N-SMI,差异有统计学意义(P<0.001)。从 CE-SMI 的微血管表现来看,血管形态和口径变化的评估在良性和恶性 GB 病变之间存在显著差异(P=0.005,P<0.001)。
使用造影剂进行 SMI 评估 GB 病变是可行的。血管形态和口径变化的存在可能有助于 GB 病变的鉴别诊断。