Shindoh N
Department of Radiology, Juntendo Urayasu Hospital, Japan.
Nihon Igaku Hoshasen Gakkai Zasshi. 1996 Feb;56(3):102-8.
Recently, the detection of polypoid lesions of the gallbladder (PLG), by using ultrasonography has been increased. Nevertheless, it is difficult to distinguish between benign PLG and malignant PLG. The purpose of this paper is to evaluate the efficacy of CT examination for differential diagnosis between benign and malignant PLG. Twenty-nine patients with PLG diagnosed by preoperative CT were retrospectively reviewed. Out of these patients, 20 patients had benign PLG and nine patients had malignant PLG. As a result, all PLG were well enhanced by contrast media. On unenhanced CT, malignant PLG appeared to be high density except one case. On the other hand, benign PLG were isodense except one case. Relatively larger amount of epithelial component of the malignant PLG contributes to high density on unenhanced CT. In contrast, benign PLG had larger amount of connective tissue, showing about the same density as bile on unenhanced CT. In conclusion, unenhanced CT examination is effective to differentiate benign PLG from malignant PLG.
近年来，通过超声检查发现的胆囊息肉样病变（PLG）有所增加。然而，区分良性PLG和恶性PLG却很困难。本文旨在评估CT检查对良性和恶性PLG进行鉴别诊断的有效性。对术前CT诊断为PLG的29例患者进行了回顾性研究。其中，20例患者为良性PLG，9例患者为恶性PLG。结果显示，所有PLG在注射造影剂后均有良好强化。在平扫CT上，除1例病例外，恶性PLG表现为高密度。另一方面，除1例病例外，良性PLG表现为等密度。恶性PLG相对较多的上皮成分导致其在平扫CT上呈高密度。相比之下，良性PLG有较多的结缔组织，在平扫CT上显示与胆汁密度大致相同。总之，平扫CT检查对鉴别良性PLG和恶性PLG有效。
