The Value of Differentiation Diagnosis of Gallbladder Polyps Larger Than 1.0cm by CEUS: 7 Years Clinical Experiences

Abstract

To assess the value of differentiation diagnosis of gallbladder polyp lesion (GPL) by contrast enhanced ultrasound (CEUS). A total of 988 consecutive cases of patients with GPL larger than 1.0cm were collected between June 2010 and May 2017 in our hospital. All patients underwent gray scale ultrasound and contrast enhanced ultrasound examinations before cholecystectomy. The patients' data and the features of GPL on gray scale ultrasound images were recorded, which include the size, color Doppler blood flow, number of GPL, echoic features of GPL and gallbladder stone. The CEUS features of GPL including enhancement intensity, enhancement homogeneous, stalk width, vascular type in arterial phase were recorded. All of the gray scale and CEUS images were analyzed by two doctors independently who have more than 10 years CEUS examinations experiences. According to the pathology findings, all the patients enrolled in this study were divided into cholesterol polyps and gallbladder adenoma groups. All the patients' data and image features between two groups were statistically compared. There were 856 cases of cholesterol polyp and 132 cases of gallbladder adenoma. There were differences in patient age, lesion size, echogenicity, gallbladder stone and vascularity of lesion between two groups (P<0.05). There were differences in stalk width, enhancement intensity and vascular types between two groups (P<0.05). Multiple logistic regression analysis proved that size of lesions, enhancement intensity, stalk of lesion, vascularity and vascular type were the independent risk factors related with GB adenoma (P<0.05). CEUS could offer useful information to distinguish adenoma from cholesterol polyp. The treatment algorithm for GPL would likely benefit from CEUS as a routine imaging investigation, especially in cases where the polyp is larger than 1cm.