title: Differential diagnosis between gallbladder adenomas and cholesterol polyps on contrast-enhanced harmonic endoscopic ultrasonography.
abstract: BACKGROUND
  Differential diagnosis between gallbladder (GB) adenomas and cholesterol polyps based on ultrasonography or endoscopic ultrasonography (EUS) is challenging because they have similar echogenicity and morphology. We evaluated the usefulness of contrast-enhanced harmonic EUS (CEH-EUS) for differentiating between GB adenomas and cholesterol polyps.
  
  
  METHODS
  Between June 2010 and December 2011, a total of 87 patients with GB polyps who underwent a CEH-EUS were reviewed retrospectively.
  
  
  RESULTS
  Of the 87 patients, 57 had a cholecystectomy. Of these, 34 patients were diagnosed with adenoma, cholesterol polyp, adenocarcinoma, or adenomyomatosis pathology. The remaining 23 patients were not diagnosed with GB polyps because their lesions separated from the GB mucosal layer during pathological sampling. On CEH-EUS, homogeneous and heterogeneous enhancement was shown in 6 and 2 patients with adenoma and in 4 and 8 patients with cholesterol polyps, respectively. Sensitivity and specificity of CEH-EUS for differential diagnosis of GB adenomas from cholesterol polyps based on the enhancement pattern were 75.0 and 66.6 %, respectively.
  
  
  CONCLUSIONS
  CEH-EUS might be useful for distinguishing GB adenomas and cholesterol polyps based on enhancement patterns. However, an additional technique such as quantitative perfusion analysis is necessary because visual assessment of CEH-EUS images is subjective.
authors.affiliation: Division of Gastroenterology, Yonsei Institute of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors.forename: Chan Hyuk
authors.initials: CH
authors.lastname: Park
authors.forename: Moon Jae
authors.initials: MJ
authors.lastname: Chung
authors.forename: Tak Geun
authors.initials: TG
authors.lastname: Oh
authors.forename: Jeong Youp
authors.initials: JY
authors.lastname: Park
authors.forename: Seungmin
authors.initials: S
authors.lastname: Bang
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Hyunki
authors.initials: H
authors.lastname: Kim
authors.forename: Ho Kyoung
authors.initials: HK
authors.lastname: Hwang
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Lee
authors.forename: Si Young
authors.initials: SY
authors.lastname: Song
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging*; D002784:Cholesterol; D003287:Contrast Media; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods; D005260:Female; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging*; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011127:Polyps / Q000000981:diagnostic imaging*; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D002784:Cholesterol