Clinical Practice Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2018; 24(6): 744-751
Published online Feb 14, 2018. doi: 10.3748/wjg.v24.i6.744
Value of contrast-enhanced ultrasound in the differential diagnosis of gallbladder lesion
Hui-Ping Zhang, Min Bai, Ji-Ying Gu, Ying-Qian He, Xiao-Hui Qiao, Lian-Fang Du
Hui-Ping Zhang, Min Bai, Ji-Ying Gu, Ying-Qian He, Xiao-Hui Qiao, Lian-Fang Du, Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
Author contributions: Zhang HP and Du LF design the research; Bai M, Gu JY and He YQ performed the research; Qiao XH analyzed the data; Zhang HP wrote the paper.
Supported by the National Natural Science Foundation of China, No. 81301232.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Shanghai General Hospital (No. 2013-094).
Informed consent statement: All study participants provided written informed consent prior to study enrollment.
Conflict-of-interest statement: None of the authors have any conflict of interest disclosures to make.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lian-Fang Du, MD, Chief Doctor, Full Professor, Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Road, Shanghai 200080, China. du_lf@163.com
Telephone: +86-21-63240090
Received: December 8, 2017
Peer-review started: December 8, 2017
First decision: December 21, 2017
Revised: January 3, 2018
Accepted: January 16, 2018
Article in press: January 16, 2018
Published online: February 14, 2018
Abstract
AIM

To describe contrast-enhanced ultrasound (CEUS) features and evaluate differential diagnosis value of CEUS and conventional ultrasound for patients with benign and malignant gallbladder lesions.

METHODS

This study included 105 gallbladder lesions. Before surgical resection and pathological examination, conventional ultrasound and CEUS were performed to examine for lesions. Then, all the lesions were diagnosed as (1) benign, (2) probably benign, (3) probably malignant or (4) malignant using both conventional ultrasound and CEUS. The CEUS features of these gallbladder lesions were analyzed and diagnostic efficiency between conventional ultrasound and CEUS was compared.

RESULTS

There were total 17 cases of gallbladder cancer and 88 cases of benign lesion. Some gallbladder lesions had typical characteristics on CEUS (e.g., gallbladder adenomyomatosis had typical characteristics of small nonenhanced areas on CEUS). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CEUS were 94.1%, 95.5%, 80.0%, 98.8% and 95.2%, respectively. These were significantly higher than conventional ultrasound (82.4%, 89.8%, 60.9%, 96.3% and 88.6%, respectively). CEUS had an accuracy of 100% for gallbladder sludge and CEUS helped in differential diagnosis among gallbladder polyps, gallbladder adenoma and gallbladder cancer.

CONCLUSION

CEUS may provide more useful information and improve the diagnosis efficiency for the diagnosis of gallbladder lesions than conventional ultrasound.

Keywords: Contrast enhanced ultrasound, Conventional ultrasound, Gallbladder carcinoma, Gallbladder adenomyomatosis

Core tip: With the advent of ultrasound contrast agents, contrast-enhanced ultrasound (CEUS) is playing a more and more important role clinically. However, the value of CEUS in gallbladder lesions has not been widely accepted yet. In this study, we evaluated the differential diagnosis value of CEUS and conventional ultrasound for patients with benign and malignant gallbladder lesions. Our results showed that CEUS may provide more useful information and improve diagnosis efficiency for the diagnosis of gallbladder lesions than conventional ultrasound.