Department of Ultrasound, the First Medical Center, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China.
Department of Ultrasound in Research and Education, Rocky Vista University, 255 East Center Street, Room C286, Ivins, UT 84738, USA.
Clin Imaging. 2021 Oct;78:8-13. doi: 10.1016/j.clinimag.2021.02.015. Epub 2021 Feb 11.
To assess the value of contrast-enhanced ultrasound (CEUS) in distinguishing adenomatous gallbladder polyps from cholesterol gallbladder polyps.
A total of 164 patients with gallbladder polyps were retrospectively analyzed. All patients underwent B-mode ultrasound (US) and CEUS before cholecystectomy. Gallbladder polyps were divided into cholesterol polyp group and adenomatous polyp group according to pathology. Differences in patient's age, gender, maximum polyp size, number, presence of gallstones, vascularity and stalk width measured by US and vascular stalk width measured by CEUS were tested between the two groups. The diagnostic performance of specific US features was evaluated. The independent factors related with adenomatous polyps were analyzed by multiple logistic regression analyses.
There were 114 cholesterol polyps and 50 adenomatous polyps in 164 patients analyzed in the study. Differences in maximum size, vascularity, and stalk width of the gallbladder polyp were significant between the two groups (p < 0.05), whereas differences in patient's age, gender, number of gallbladder polyp, and presence of gallstones between the two groups were not (p > 0.05). Stalk width was wider than vascular stalk width between the two groups (p < 0.05). Vascular stalk width was also statistically different between the two groups (p < 0.05). The diagnostic performance of vascular stalk width was more significant than stalk width. Only vascular stalk width and vascularity were independent factors related with adenomatous polyps.
Vascular stalk width measured by CEUS is more accurate than stalk width measured by grayscale US in distinguishing adenomatous polyps from cholesterol polyps.
评估超声造影（CEUS）在鉴别胆囊腺瘤性息肉和胆固醇性息肉中的价值。
回顾性分析 164 例胆囊息肉患者。所有患者均在胆囊切除术前接受了 B 型超声（US）和 CEUS 检查。根据病理结果将胆囊息肉分为胆固醇息肉组和腺瘤性息肉组。比较两组患者的年龄、性别、最大息肉大小、数量、胆囊结石、US 测量的息肉血管和蒂宽度及 CEUS 测量的蒂血管宽度的差异。评估特定 US 特征的诊断性能。采用多因素 logistic 回归分析分析与腺瘤性息肉相关的独立因素。
本研究共分析了 164 例患者的 114 个胆固醇息肉和 50 个腺瘤性息肉。两组患者的最大息肉大小、血管密度和蒂宽度差异有统计学意义（p<0.05），而两组患者的年龄、性别、胆囊息肉数量和胆囊结石存在差异无统计学意义（p>0.05）。两组间息肉蒂的宽度大于蒂血管的宽度（p<0.05）。两组间蒂血管的宽度也存在统计学差异（p<0.05）。蒂血管的宽度的诊断性能优于蒂宽度。只有蒂血管的宽度和血管密度是与腺瘤性息肉相关的独立因素。
CEUS 测量的蒂血管的宽度比灰阶 US 测量的蒂宽度更准确，有助于鉴别胆囊腺瘤性息肉和胆固醇性息肉。
