The value of contrast-enhanced ultrasound in the differential diagnosis of polypoid lesions of gallbladder

Objective To investigate the value of contrast-enhanced ultrasound in the differential diagnosis of polypoid lesions of gallbladder. Methods Contrast-enhanced ultrasound data from 112 patients with polypoid lesions of gallbladder(18 patients with gallbladder carcinoma, 20 patients with gallbladder adenomas, 63 patients with cholesterol polyps and inflammatory polyps, 5 patients with biliary sludge and 6 patients with adenomyomatosis of gallbladder) were retrospectively analyzed, including the initial enhancement time, enhancement level, enhanced vascular morphology, integrality of gallbladder wall adjacent to lesions and characteristics of basement of lesions. All lesions were confirmed by pathology. Results The lesions were bigger in patients with gallbladder carcinoma than those in other groups(t=1.474, 8.553, 3.984, 1.362, 3.488, all P 0.05). Patients with biliary sludge showed no enhancement, while most of patients with other lesions showed hyper-enhancement during initial period and hypo-enhancement during late period. The time to initial enhancement was significantly shorter in patients with gallbladder carcinoma than that in patients with gallbladder adenomas and cholesterol polyps(t=2.321, 2.219, both P 0.05). The time to peak enhancement was significantly shorter in patients with gallbladder carcinoma than that in patients with other lesions(t=3.562, 4.588, 2.004, 12.361, all P 0.05). The time to iso-enhancement in patients with cholesterol polyps was significantly shorter than that in patients with gallbladder carcinoma and gallbladder adenomas(t=5.407, 2.924, both P 0.05). The time to hypo-enhancement in patients with gallbladder adenomas was significantly longer than that in other groups(t=3.109, 6.342, 1.811, 6.012, all P 0.05). When compared with other groups, the width of basement increased and the integrality of gallbladder wall destructed in patients with gallbladder carcinoma. Conclusions CEUS is an important supplement for the routine ultrasonography of polypoid lesions of gallbladder. A comprehensive analysis of gallbladder enhancement model, enhancement time and morphological changes of gallbladder wall is useful in the differential diagnosis of polypoid lesions of gallbladder.