Differential diagnosis of polypoid lesions of the gallbladder by endoscopic ultrasonography.
BACKGROUND
Transabdominal ultrasonography (US) has made the detection of gallbladder polyps easier, but the differential diagnosis of polyps less than 20 mm remains difficult. Therefore, we evaluated the usefulness of endoscopic ultrasonography (EUS) for the differential diagnosis of gallbladder polyps.


METHODS
Among patients with gallbladder polyps less than 20 mm, we reviewed 89 patients who underwent US and EUS before surgery and assessed the results of differential diagnoses by them.


RESULTS
In all, 86.5% of these polyps were precisely diagnosed by EUS. However, only 51.7% were diagnosed by US. Sensitivity, specificity, and positive and negative predictive values of EUS at the diagnosis of carcinoma were 91.7%, 87.7%, 75.9%, and 96.6%, respectively. Those of US were 54.2%, 53.8%, 54.2%, and 94.6%, respectively.


CONCLUSIONS
EUS may markedly improve the accuracy of the differential diagnosis of gallbladder polyps. Therefore, EUS is thought to play an important role in determining the treatment strategy for gallbladder polyps.
Department of Gastroenterological Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, 162-8666, Tokyo, Japan. Azumido@aol.com
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Azuma
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Yoshikawa
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Araida
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Takasaki
D000230:Adenocarcinoma / Q000000981:diagnostic imaging*; D018256:Adenomatous Polyps / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D019160:Endosonography; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D011127:Polyps / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity