Contrast-enhanced endoscopic ultrasonography in gallbladder diseases.
BACKGROUND
The purpose of this study was to investigate the usefulness of contrast-enhanced endoscopic ultrasonography in gallbladder diseases.


METHODS
Subjects were 38 patients including 12 with adenocarcinoma, 2 adenosquamous carcinoma, 6 cholesterol polyp, 10 cholecystitis, and 8 adenomyomatosis. After endoscopic ultrasonography, sonicated albumin was intravenously injected and the enhanced effect on images of these lesions was determined. For malignancies we compared diagnostic accuracy (T factor, TNM classification) of endoscopic ultrasonography and contrast-enhanced endoscopic ultrasonography. Vascularity as shown by contrast-enhanced endoscopic ultrasonography and angiograms was compared.


RESULTS
Enhancement was observed in 11 patients with adenocarcinoma but not of those with adenosquamous carcinoma or cholesterol polyp. Angiography provided hypervascular images for all cases of adenocarcinoma, but all other lesions were hypovascular. In one case of adenocarcinoma, 3 cases of adenomyomatosis, and 8 cases of cholecystitis, there was a discrepancy between contrast-enhanced endoscopic ultrasonography images and angiograms with regard to vascularity. The accuracy of depth of tumor invasion for endoscopic ultrasonography was 78.6% (11 of 14) versus 92.9% (13 of 14) for contrast-enhanced endoscopic ultrasonography.


CONCLUSIONS
Contrast-enhanced endoscopic ultrasonography is useful in the diagnosis of gallbladder lesions.
Hirooka
Y
Y
Second Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Naitoh
Y
Y
Goto
H
H
Ito
A
A
Hayakawa
S
S
Watanabe
Y
Y
Ishiguro
Y
Y
Kojima
S
S
Hashimoto
S
S
Hayakawa
T
T
D000230:Adenocarcinoma / Q000000981:diagnostic imaging; D018194:Adenomyoma / Q000000981:diagnostic imaging; D000418:Albumins; D002764:Cholecystitis / Q000000981:diagnostic imaging*; D003287:Contrast Media; D019160:Endosonography / Q000379:methods*; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D008863:Microspheres; D011127:Polyps / Q000000981:diagnostic imaging
D000418:Albumins; C060687:Albunex; D003287:Contrast Media