Pre-operative predictive factors for gallbladder cholesterol polyps using conventional diagnostic imaging.
OBJECTIVE
To determine the clinical data that might be useful for differentiating benign from malignant gallbladder (GB) polyps by comparing radiological methods, including abdominal ultrasonography (US) and computed tomography (CT) scanning, with postoperative pathology findings.


METHODS
Fifty-nine patients underwent laparoscopic cholecystectomy for a GB polyp of around 10 mm. They were divided into two groups, one with cholesterol polyps and the other with non-cholesterol polyps. Clinical features such as gender, age, symptoms, size and number of polyps, the presence of a GB stone, the radiologically measured maximum diameter of the polyp by US and CT scanning, and the measurements of diameter from postoperative pathology were recorded for comparative analysis.


RESULTS
Fifteen of the 41 cases with cholesterol polyps (36.6%) were detected with US but not CT scanning, whereas all 18 non-cholesterol polyps were observed using both methods. In the cholesterol polyp group, the maximum measured diameter of the polyp was smaller by CT scan than by US. Consequently, the discrepancy between those two scanning measurements was greater than for the non-cholesterol polyp group.


CONCLUSIONS
The clinical signs indicative of a cholesterol polyp include: (1) a polyp observed by US but not observable by CT scanning, (2) a smaller diameter on the CT scan compared to US, and (3) a discrepancy in its maximum diameter between US and CT measurements. In addition, US and the CT scan had low accuracy in predicting the polyp diameter compared to that determined by postoperative pathology.
Choi
Ji-Hoon
JH
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 110-746, South Korea.
Yun
Jung-Won
JW
Kim
Yong-Sung
YS
Lee
Eun-A
EA
Hwang
Sang-Tae
ST
Cho
Yong-Kyun
YK
Kim
Hong-Joo
HJ
Park
Jung-Ho
JH
Park
Dong-Il
DI
Sohn
Chong-Il
CI
Jeon
Woo-Kyu
WK
Kim
Byung-Ik
BI
Kim
Hyoung-Ook
HO
Shin
Jun-Ho
JH
D000328:Adult; D017081:Cholecystectomy, Laparoscopic; D002784:Cholesterol / Q000032:analysis*; D003937:Diagnosis, Differential; D005260:Female; D005705:Gallbladder Diseases / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000737:chemistry / Q000175:diagnosis* / Q000601:surgery; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D002784:Cholesterol