Value of contrast-enhanced ultrasound in the differential diagnosis of gallbladder lesion

Figure 1 Gallbladder sludge in a 54-year-old female patient. A: B-mode sonography showed a hypoechoic, well-defined mass in the gallbladder, with an intact gallbladder wall; B: Color Doppler ultrasound showed no color Doppler signal in the lesion. According to A and B, a diagnosis of probably benign was made; C: CEUS showed complete nonenhancement on arterial phase; D: CEUS showed complete nonenhancement on venous phase. According to C and D, a diagnosis of benign gallbladder sludge was made. CEUS: Contrast-enhanced ultrasound.

Figure 2 Gallbladder adenomyomatosis in a 62-year-old male patient. A: B-mode sonography showed a heterogeneously hypoechoic lesion on the gallbladder wall, with an intact gallbladder wall; B: Color Doppler ultrasound showed no color Doppler signal in the lesion. According to A and B, a diagnosis of probably benign was made. C: CEUS showed heterogeneously enhanced, with some small nonenhanced areas, on arterial phase; D: CEUS showed heterogeneously enhanced, with some small nonenhanced areas, on venous phase. According to C and D, a diagnosis of benign gallbladder adenomyomatosis was made. CEUS: Contrast-enhanced ultrasound.

Figure 3 Gallbladder polyps in a 38-year-old male patient. A: B-mode sonography showed a homogeneously isoechoic lesion in the gallbladder, with an intact gallbladder wall; B: Color Doppler ultrasound showed no color Doppler signal in the lesion. According to A and B, a diagnosis of probably benign was made. C: CEUS showed a homogeneous and a little hyperenhanced lesion in the gallbladder on arterial phase; D: CEUS showed the enhancement of the lesion is similar to the surrounding gallbladder wall on venous phase. According to C and D, a diagnosis of benign lesion was made. CEUS: Contrast-enhanced ultrasound.

Figure 4 Gallbladder cancer in a 46-year-old male patient. A: B-mode sonography showed a heterogeneously hypoechoic mass in the gallbladder, and the posterior wall of the gallbladder was not very clear; B: Color Doppler ultrasound showed no color Doppler signal in the lesion. According to A and B, a diagnosis of probably malignant was made. C: CEUS showed a heterogeneously hyperenhanced mass with tortuous-type tumor vessel on arterial phase and the boundary of the mass was not clear; D: CEUS showed the enhancement of the lesion is much lower than that of the surrounding gallbladder wall on venous phase. According to C and D, a diagnosis of malignant mass was made. CEUS: Contrast-enhanced ultrasound.