Cargando…

Is Contrast-Enhanced Ultrasound Superior to Computed Tomography for Differential Diagnosis of Gallbladder Polyps? A Cross-Sectional Study

OBJECTIVE: To compare the clinical value of contrast-enhanced ultrasonography (CEUS) versus computed tomography (CT) for distinguishing neoplastic and non-neoplastic gallbladder polyps. Given whether laparoscopic cholecystectomy is needed, differential diagnosis of neoplastic and non-neoplastic gall...

Descripción completa

Detalles Bibliográficos
Autores principales: Yuan, Zhiqing, Liu, Xuesong, Li, Qiwei, Zhang, Yunhe, Zhao, Ling, Li, Fenghua, Chen, Tao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8181139/
https://www.ncbi.nlm.nih.gov/pubmed/34109116
http://dx.doi.org/10.3389/fonc.2021.657223
_version_ 1783704066465988608
author Yuan, Zhiqing
Liu, Xuesong
Li, Qiwei
Zhang, Yunhe
Zhao, Ling
Li, Fenghua
Chen, Tao
author_facet Yuan, Zhiqing
Liu, Xuesong
Li, Qiwei
Zhang, Yunhe
Zhao, Ling
Li, Fenghua
Chen, Tao
author_sort Yuan, Zhiqing
collection PubMed
description OBJECTIVE: To compare the clinical value of contrast-enhanced ultrasonography (CEUS) versus computed tomography (CT) for distinguishing neoplastic and non-neoplastic gallbladder polyps. Given whether laparoscopic cholecystectomy is needed, differential diagnosis of neoplastic and non-neoplastic gallbladder polyps is more important than benign and malignant polyps. METHODS: A total of 89 consecutive patients with polypoid lesions of the gallbladder > 10 mm in size without local invasion or distant metastasis during primary screening were enrolled in this prospective and comparative study. All patients who met the inclusion criteria underwent CEUS and CT examinations prior to surgical resection. The enhancement patterns and microvascular imaging types were analyzed on CEUS. The maximum diameter and CT value of the lesions were also recorded and subjected to a comparative analysis. The clinical value of the two diagnostic methods is compared. RESULTS: Of the 89 patients, there were 58 (65.2%) cases of non-neoplastic polyps and 31 (34.8%) cases of neoplastic polyps. The average diameter of neoplastic polyps was significantly higher than that of non-neoplastic polyps (P<0.001). The detection rate using CEUS was 100%. The proportion of perceived non-neoplastic polyps in the nonenhanced and arterial phases were 48.3% and 77.6%, respectively, which were significantly lower than those of neoplastic polyps (93.5%, P<0.001 and 100.0%, P<0.001, respectively). However, in the venous and delayed phases, all cholesterol polyps and neoplastic polyps were perceived. CT showed that non-neoplastic polyps exhibited delayed enhancement. On CEUS 29.0% neoplastic polyps showed a perfusion defect, whereas 6.9% non-neoplastic polyps showed a perfusion defect (P=0.005). The microvascular architecture of the lesions on CEUS was categorized into 4 types: spotty, linear, branched, and spinous, and there were significant differences between the two groups (P<0.001). The sensitivities and specificities were 87.10% and 68.97% for CEUS and 83.87% and 77.59% for CT, respectively (P=0.406). CONCLUSIONS: CEUS and CT are useful for differential diagnosis of neoplastic and nonneoplastic polypoid lesions of the gallbladder. Diagnostic efficacy was comparable between CEUS and CT. Thus, CEUS is preferred over CT in the differential diagnosis of neoplastic and non-neoplastic gallbladder polyps due to its comparable diagnostic efficacy and lack of radiation dose.
format Online
Article
Text
id pubmed-8181139
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-81811392021-06-08 Is Contrast-Enhanced Ultrasound Superior to Computed Tomography for Differential Diagnosis of Gallbladder Polyps? A Cross-Sectional Study Yuan, Zhiqing Liu, Xuesong Li, Qiwei Zhang, Yunhe Zhao, Ling Li, Fenghua Chen, Tao Front Oncol Oncology OBJECTIVE: To compare the clinical value of contrast-enhanced ultrasonography (CEUS) versus computed tomography (CT) for distinguishing neoplastic and non-neoplastic gallbladder polyps. Given whether laparoscopic cholecystectomy is needed, differential diagnosis of neoplastic and non-neoplastic gallbladder polyps is more important than benign and malignant polyps. METHODS: A total of 89 consecutive patients with polypoid lesions of the gallbladder > 10 mm in size without local invasion or distant metastasis during primary screening were enrolled in this prospective and comparative study. All patients who met the inclusion criteria underwent CEUS and CT examinations prior to surgical resection. The enhancement patterns and microvascular imaging types were analyzed on CEUS. The maximum diameter and CT value of the lesions were also recorded and subjected to a comparative analysis. The clinical value of the two diagnostic methods is compared. RESULTS: Of the 89 patients, there were 58 (65.2%) cases of non-neoplastic polyps and 31 (34.8%) cases of neoplastic polyps. The average diameter of neoplastic polyps was significantly higher than that of non-neoplastic polyps (P<0.001). The detection rate using CEUS was 100%. The proportion of perceived non-neoplastic polyps in the nonenhanced and arterial phases were 48.3% and 77.6%, respectively, which were significantly lower than those of neoplastic polyps (93.5%, P<0.001 and 100.0%, P<0.001, respectively). However, in the venous and delayed phases, all cholesterol polyps and neoplastic polyps were perceived. CT showed that non-neoplastic polyps exhibited delayed enhancement. On CEUS 29.0% neoplastic polyps showed a perfusion defect, whereas 6.9% non-neoplastic polyps showed a perfusion defect (P=0.005). The microvascular architecture of the lesions on CEUS was categorized into 4 types: spotty, linear, branched, and spinous, and there were significant differences between the two groups (P<0.001). The sensitivities and specificities were 87.10% and 68.97% for CEUS and 83.87% and 77.59% for CT, respectively (P=0.406). CONCLUSIONS: CEUS and CT are useful for differential diagnosis of neoplastic and nonneoplastic polypoid lesions of the gallbladder. Diagnostic efficacy was comparable between CEUS and CT. Thus, CEUS is preferred over CT in the differential diagnosis of neoplastic and non-neoplastic gallbladder polyps due to its comparable diagnostic efficacy and lack of radiation dose. Frontiers Media S.A. 2021-05-24 /pmc/articles/PMC8181139/ /pubmed/34109116 http://dx.doi.org/10.3389/fonc.2021.657223 Text en Copyright © 2021 Yuan, Liu, Li, Zhang, Zhao, Li and Chen https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Yuan, Zhiqing
Liu, Xuesong
Li, Qiwei
Zhang, Yunhe
Zhao, Ling
Li, Fenghua
Chen, Tao
Is Contrast-Enhanced Ultrasound Superior to Computed Tomography for Differential Diagnosis of Gallbladder Polyps? A Cross-Sectional Study
title Is Contrast-Enhanced Ultrasound Superior to Computed Tomography for Differential Diagnosis of Gallbladder Polyps? A Cross-Sectional Study
title_full Is Contrast-Enhanced Ultrasound Superior to Computed Tomography for Differential Diagnosis of Gallbladder Polyps? A Cross-Sectional Study
title_fullStr Is Contrast-Enhanced Ultrasound Superior to Computed Tomography for Differential Diagnosis of Gallbladder Polyps? A Cross-Sectional Study
title_full_unstemmed Is Contrast-Enhanced Ultrasound Superior to Computed Tomography for Differential Diagnosis of Gallbladder Polyps? A Cross-Sectional Study
title_short Is Contrast-Enhanced Ultrasound Superior to Computed Tomography for Differential Diagnosis of Gallbladder Polyps? A Cross-Sectional Study
title_sort is contrast-enhanced ultrasound superior to computed tomography for differential diagnosis of gallbladder polyps? a cross-sectional study
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8181139/
https://www.ncbi.nlm.nih.gov/pubmed/34109116
http://dx.doi.org/10.3389/fonc.2021.657223
work_keys_str_mv AT yuanzhiqing iscontrastenhancedultrasoundsuperiortocomputedtomographyfordifferentialdiagnosisofgallbladderpolypsacrosssectionalstudy
AT liuxuesong iscontrastenhancedultrasoundsuperiortocomputedtomographyfordifferentialdiagnosisofgallbladderpolypsacrosssectionalstudy
AT liqiwei iscontrastenhancedultrasoundsuperiortocomputedtomographyfordifferentialdiagnosisofgallbladderpolypsacrosssectionalstudy
AT zhangyunhe iscontrastenhancedultrasoundsuperiortocomputedtomographyfordifferentialdiagnosisofgallbladderpolypsacrosssectionalstudy
AT zhaoling iscontrastenhancedultrasoundsuperiortocomputedtomographyfordifferentialdiagnosisofgallbladderpolypsacrosssectionalstudy
AT lifenghua iscontrastenhancedultrasoundsuperiortocomputedtomographyfordifferentialdiagnosisofgallbladderpolypsacrosssectionalstudy
AT chentao iscontrastenhancedultrasoundsuperiortocomputedtomographyfordifferentialdiagnosisofgallbladderpolypsacrosssectionalstudy