Value of contrast-enhanced ultrasound in differential diagnosis of wall-thickening gallbladder lesions

doi:10.3877/cma.j.issn.2095-3232.2019.02.017

Abstract

Abstract:

Objective

To evaluate contrast-enhanced ultrasound (CEUS) in the differential diagnosis of wall-thickening gallbladder lesions.

Methods

Clinical data of 61 patients with wall-thickening gallbladder lesions undergoing surgery in the Third Affiliated Hospital of Sun Yat-sen University from April 2006 to August 2018 were retrospectively analyzed. Among them, 36 patients were male and 25 female, aged (56±11) years on average. The informed consents of all patients were obtained and the local ethical committee approval was received. All patients received CEUS and enhanced CT before operation. The pathological examination results were taken as the gold standard. The values of CEUS and enhanced CT in the differential diagnosis of wall-thickening gallbladder lesions were evaluated by the receiver operating characteristic (ROC) curve. The rate comparison was conducted by Chi-square test or Fisher's exact test.

Results

Pathological examination indicated that 27 cases were with gallbladder adenocarcinoma, 26 chronic cholecystitis and 8 gallbladder adenomyosis. Inhomogeneous enhancement and homogeneous enhancement were observed respectively in 24 and 3 patients with gallbladder adenocarcinoma by CEUS, in 20 and 6 patients with chronic cholecystitis, and in 7 and 1 patients with gallbladder adenomyosis, where significant difference was observed (χ²=28.40, P<0.05). Continuous interruption of external wall and continuous interruption of internal wall were observed respectively in 19 and 21 patients with gallbladder adenocarcinoma, and in 2 and 5 patients with chronic cholecystitis correspondingly, whereas continuous interruption of internal wall was observed in only 1 patients with gallbladder adenomyosis, where significant difference was observed (P<0.05). The specificity, sensitivity, positive and negative predictive values of CEUS and enhanced CT in the differential diagnosis from benign to malignant wall-thickening gallbladder lesions were 0.79, 0.88, 0.77, 0.90 and 0.82, 0.85, 0.79, 0.88, respectively.

Conclusions

CEUS shows inhomogeneous enhancement in the gallbladder wall. Continuous interruption of the internal or external gallbladder walls contributes to the differential diagnosis between benign and malignant wall-thickening gallbladder lesions. CEUS and CT scan share equivalent diagnostic values.

Key words: Ultrasonography, interventional, Gallbladder wall thickening diseases, Gallbladder carcinoma, Diagnosis, differential

Xiaoli Wang, Ma Li, Zeping Huang. Value of contrast-enhanced ultrasound in differential diagnosis of wall-thickening gallbladder lesions[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2019, 08(02): 159-163.

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References 20

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病理诊断（例）	例数	性别（例）		年龄（岁，±s）	胆囊壁厚度（mm，±s）
病理诊断（例）	例数	男	女	年龄（岁，±s）	胆囊壁厚度（mm，±s）
胆囊癌	27	16	11	66±13	14.5±4.2
慢性胆囊炎	26	15	11	48±16	09.1±2.3
胆囊腺肌症	08	05	03	45±11	08.2±2.6
统计值		χ²=0.06		F=-13.80	F=-21.80
P值		>0.05		<0.05	<0.05

病理诊断（例）	例数	性别（例）		年龄（岁，±s）	胆囊壁厚度（mm，±s）
病理诊断（例）	例数	男	女	年龄（岁，±s）	胆囊壁厚度（mm，±s）
胆囊癌	27	16	11	66±13	14.5±4.2
慢性胆囊炎	26	15	11	48±16	09.1±2.3
胆囊腺肌症	08	05	03	45±11	08.2±2.6
统计值		χ²=0.06		F=-13.80	F=-21.80
P值		>0.05		<0.05	<0.05

病理诊断	例数	开始增强时间（s，±s）	增强变等时间（s，±s）	增强水平（例）			增强模式（例）		胆囊外壁连续性（例）		胆囊内壁连续性（例）
病理诊断	例数	开始增强时间（s，±s）	增强变等时间（s，±s）	高	等	低	均匀	不均匀	连续	不连续	连续	不连续
胆囊癌	27	17±3	33±6	24	2	1	0.3	24	008	19	0..6	21
慢性胆囊炎	26	15±3	29±8	22	4	0	20	6	24	2	21	5
胆囊腺肌症	08	15±3	30±6	7	1	0	07	1	08	0	07	1
统计值		F=-2.90	F=-2.20	-			χ²=28.40		-		χ²=22.20
P值		>0.05	>0.05	>0.05			<0.05		<0.05		<0.05

病理诊断	例数	开始增强时间（s，±s）	增强变等时间（s，±s）	增强水平（例）			增强模式（例）		胆囊外壁连续性（例）		胆囊内壁连续性（例）
病理诊断	例数	开始增强时间（s，±s）	增强变等时间（s，±s）	高	等	低	均匀	不均匀	连续	不连续	连续	不连续
胆囊癌	27	17±3	33±6	24	2	1	0.3	24	008	19	0..6	21
慢性胆囊炎	26	15±3	29±8	22	4	0	20	6	24	2	21	5
胆囊腺肌症	08	15±3	30±6	7	1	0	07	1	08	0	07	1
统计值		F=-2.90	F=-2.20	-			χ²=28.40		-		χ²=22.20
P值		>0.05	>0.05	>0.05			<0.05		<0.05		<0.05

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