The role of contrast-enhanced ultrasound in the differentiation between gallbladder adenoma and carcinoma developing from gallbladder adenoma

Abstract

Objectives To investigate the role of contrast-enhanced ultrasound in the differentiation between gallbladder adenoma and carcinoma developing from gallbladder adenoma.Methods The data from 28 patients who received contrast-enhanced ultrasound (19 patients with gallbladder adenoma and 9 patients with gallbladder carcinoma developing from gallbladder adenoma) were retrospectively analyzed.We analyzed the contrast enhancement characteristics of the initial enhancement time,the enhancement level,enhanced morphology and the integrity of gallbladder wall adjacent to the lesions.All the lesions were confirmed by histopathology.Results The time to initial enhancement and the time to peak enhancement were significantly shorter in patients with gallbladder adenoma than in patients with gallbladder carcinoma developing from gallbladder adenoma [(13.11 + 3.63)s vs.(18.11-±-3.26)s,(17.36+3.95)s vs.(24.56-±-4.36)s,all P＜0.01].The time to iso-enhancement,however,showed no significant differences.The time to hypo-enhancement and enhancement time of the liver were significantly shorter in patients with gallbladder carcinoma developing from gallbladder adenoma than in patients with gallbladder adenoma [(55.56 ± 15.4) s vs.(91.00 ± 34.25) s,P＜0.01,(16.63+4.66)svs.(22.78+5.29)s,P＜0.05].Using ROC curve,the time to peak enhancement value greater than 20 s had a sensitivity of 89 ％ and a specificity of 85 ％ for detecting gallbladder carcinoma developing from gallbladder adenoma.The enhancement level showed no significant difference between the two groups.Inhomogeneous enhancement was found in 3 (33 ％) gallbladder cancer developing from gallbladder adenoma and none (0/19) in gallbladder adenoma (P＜0.01).Destruction of the integrity of gallbladder wall was found in 6 (66.7％) gallbladder carcinoma developing from gallbladder adenoma and none (0/19) in gallbladder adenoma (P＜0.01).Conclusions Contrast-enhanced ultrasound is useful in the identification of patients with gallbladder adenoma and gallbladder carcinoma developing from gallbladder adenoma.The time to peak enhancement,the enhancement morphology and the integrity of gallbladder wall adjacent to the lesions significantly improved the ability to differentiate between gallbladder adenoma and gallbladder carcinoma developing from gallbladder adenoma. Key words: Gallbladder neoplasms; Ultrasonography