title: Contrast-enhanced ultrasound versus conventional ultrasound in the diagnosis of polypoid lesion of gallbladder: a multi-center study of dynamic microvascularization.
abstract: OBJECTIVE
  To assess the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of polypoid lesions of gallbladder (PLGs).
  
  
  METHODS
  CEUS was performed to 116 patients (mean age, 49.6 years; range, 21-80 years) with PLGs from 8 university hospitals. 9 cases of biliary sludge were proven by surgery and the remaining 107 cases were confirmed by histopathological examination. The confidence level, diagnostic performance, inter-observer agreement of two independent readers with different experience was assessed. The readers were blind to the imaging and clinical results of the patients.
  
  
  RESULTS
  There were significant differences between benign and malignant PLGs in patient age, gender, lesion size, echogenicity, stalk, time-to-peak, vascularity on CEUS, enhancement pattern, and wall destruction. The confidence levels increased significantly and the interobserver agreement increased from 0.425 to 0.601 after CEUS. The sensitivity increased from 22.2 to 77.8% after CEUS in the staff radiologist, and from 22.2 to 66.7% in the resident radiologist. The correctly characterized lesions were 64.7% before versus 87.1% after CEUS (P=0.125) for the staff radiologist, and 57.8% versus 70.7% for the resident radiologist (P=0.007). No significance was found in the subgroup of lesions≤1.0 cm before and after CEUS for the two radiologists.
  
  
  CONCLUSIONS
  CEUS using convex multifrequency probes could detect the dynamic microvascularization of PLGs greater than 1.0 cm and facilitate the differentiation between benign and malignant tumors.
authors.affiliation: Department of Medical Ultrasound, Tenth People's Hospital of Tongji University, Shanghai Tenth People's Hospital, Shanghai, China Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Shu-Guang
authors.initials: SG
authors.lastname: Zheng
authors.affiliation: Department of Medical Ultrasound, Tenth People's Hospital of Tongji University, Shanghai Tenth People's Hospital, Shanghai, China Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Hui-Xiong
authors.initials: HX
authors.lastname: Xu
authors.affiliation: Department of Medical Ultrasound, Tenth People's Hospital of Tongji University, Shanghai Tenth People's Hospital, Shanghai, China.
authors.forename: Lin-Na
authors.initials: LN
authors.lastname: Liu
authors.affiliation: Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Ming-De
authors.initials: MD
authors.lastname: Lu
authors.affiliation: Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Xie
authors.affiliation: Department of Ultrasound, Zhongshan Hospital of Fudan University, Shanghai, China.
authors.forename: Wen-Ping
authors.initials: WP
authors.lastname: Wang
authors.affiliation: Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Hu
authors.affiliation: Department of Ultrasound, Peking University School of Oncology, Beijing Cancer Institute, Beijing, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Yan
authors.affiliation: Department of Ultrasound, Zhongshan Hospital of Fudan University, Shanghai, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Ding
authors.affiliation: Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Shao-Shan
authors.initials: SS
authors.lastname: Tang
authors.affiliation: Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Lin-Xue
authors.initials: LX
authors.lastname: Qian
authors.affiliation: Department of Ultrasound, Second Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Bao-Ming
authors.initials: BM
authors.lastname: Luo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D005704:Gallbladder / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000473:pathology; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging* / Q000235:genetics / Q000473:pathology; D006801:Humans; D008297:Male; D055806:Microvessels / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D011123:Polyploidy; D011446:Prospective Studies; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Contrast-enhanced ultrasound; differential diagnosis; gallbladder; polypoid lesion