Zhu Lian-Hua, Fei Xiang, Han Peng, Li Nan, Liang Shu-Yuan, Luo Yu-Kun
Department of Ultrasound,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2021 Jun 30;43(3):350-356. doi: 10.3881/j.issn.1000-503X.13791.
Objective To compare the performance of contrast-enhanced ultrasound(CEUS)and ultrasound(US)in the differential diagnosis between cholesterol polyps and gallbladder adenomas. Methods A total of 136 patients with gallbladder polyp lesions(GPLs)and undergoing cholecystectomy in the First Medical Center of Chinese PLA General Hospital from January 2019 to October 2020 were retrospectively analyzed.All the patients underwent US and CEUS examinations before cholecystectomy.US and CEUS images of cholesterol polyps and gallbladder adenomas were compared for the evaluation of the performance of CEUS in the diagnosis of gallbladder adenomas. Results The 136 cases of GPLs included 95 cases of cholesterol polyps and 41 cases of gallbladder adenomas.Cholesterol polyps and gallbladder adenomas showed significant differences in the maximum size of GPLs( =-5.189, <0.001), polyp blood flow signal( =33.630, <0.001), vascular stalk width(=-7.366, <0.001), polyp enhancement time( =22.487, <0.001), enhancement intensity in arterial phase( =44.371, <0.001), polyp vascular morphology( =53.814, <0.001)and gallbladder wall integrity( =13.277, =0.001).The sensitivity, specificity and accuracy of CEUS in distinguishing gallbladder adenomas from cholesterol polyps were 85.37%, 89.47% and 88.24%, respectively, and the area under the curve was 0.874. Conclusion CEUS can effectively distinguish gallbladder adenomas from cholesterol polyps and help patients with GPLs to select the appropriate treatment.
目的 比较超声造影(CEUS)与普通超声(US)在胆固醇性息肉和胆囊腺瘤鉴别诊断中的性能。方法 回顾性分析2019年1月至2020年10月在中国人民解放军总医院第一医学中心接受胆囊切除术的136例胆囊息肉样病变(GPLs)患者。所有患者在胆囊切除术前均接受了US和CEUS检查。比较胆固醇性息肉和胆囊腺瘤的US及CEUS图像,以评估CEUS在胆囊腺瘤诊断中的性能。结果 136例GPLs中,胆固醇性息肉95例,胆囊腺瘤41例。胆固醇性息肉和胆囊腺瘤在GPLs最大径(=-5.189,<0.001)、息肉血流信号(=33.630,<0.001)、血管蒂宽度(=-7.366,<0.001)、息肉增强时间(=22.487,<0.001)、动脉期增强强度(=44.371,<0.001)、息肉血管形态(=53.814,<0.001)及胆囊壁完整性(=13.277,=0.001)方面存在显著差异。CEUS鉴别胆囊腺瘤与胆固醇性息肉的敏感度、特异度和准确度分别为85.37%、89.47%和88.24%,曲线下面积为0.874。结论 CEUS能有效鉴别胆囊腺瘤与胆固醇性息肉,有助于GPLs患者选择合适的治疗方案。