title: Contrast-enhanced ultrasonography in the diagnosis of gallbladder disease.
abstract: OBJECTIVE
  The aim of our study was to evaluate the enhancement patterns of gallbladder disease using contrast-enhanced ultrasonography (CE-US) with the contrast agent levovist.
  
  
  METHODS
  The subjects were 42 patients, of whom 25 had gallbladder cancer, 2 had adenoma, 5 had adenomyomatosis, 5 had cholesterol polyps and 5 had debris. We assessed the enhancement patterns of each case using CE-US with levovist and classified these patterns into 6 types: diffuse, scattered, branched, linear, homogeneous and unenhanced.
  
  
  RESULTS
  The enhancement of gallbladder cancer revealed various patterns. Only 4 malignant cases showed branched patterns. We speculated that branched patterns in the present study were possibly the characteristic of malignancy. CE-US easily distinguished a small polypoid lesion from debris. Using CE-US, we visualized the shape of the gallbladder cancer lesions and some areas of direct invasion to the liver, as well as metastasis.
  
  
  CONCLUSIONS
  CE-US is a minimally invasive diagnostic technique that is useful in visualizing not only the shape of the lesion and some areas of the direct invasion to the liver, but also metastasis. The above findings suggest that imaging using a contrast agent could lead to improvements in the diagnosis of gallbladder lesions.
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. g.shujihiro@gmail.com
authors.forename: Shujiro
authors.initials: S
authors.lastname: Tsuji
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sofuni
authors.forename: Fuminori
authors.initials: F
authors.lastname: Moriyasu
authors.forename: Fumihide
authors.initials: F
authors.lastname: Itokawa
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ishii
authors.forename: Toshio
authors.initials: T
authors.lastname: Kurihara
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Ikeuchi
authors.forename: Junko
authors.initials: J
authors.lastname: Umeda
authors.forename: Reina
authors.initials: R
authors.lastname: Tanaka
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging / Q000473:pathology; D018194:Adenomyoma / Q000000981:diagnostic imaging / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D042882:Gallstones / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011127:Polyps / Q000000981:diagnostic imaging; D011134:Polysaccharides; D011237:Predictive Value of Tests; D011379:Prognosis; D018615:Ultrasonography, Doppler, Color
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508