title: Differential diagnosis of polypoid lesions of the gallbladder using contrast-enhanced sonography.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the usefulness of real-time contrast-enhanced sonography and microvascular imaging for differential diagnosis of neoplastic and non-neoplastic polypoid lesions of the gallbladder.
  
  
  METHODS
  Real-time contrast-enhanced sonography and microvascular imaging were performed in 128 patients with polypoid lesions of the gallbladder larger than 6 mm in diameter. The enhancement patterns, microvascular imaging types, and kinetic parameters were analyzed on contrast-enhanced sonography. The maximum diameters of the lesions measured by conventional and contrast-enhanced sonography were also recorded and subjected to a comparative analysis.
  
  
  RESULTS
  Among the 128 patients, histologic diagnoses were obtained in 83 (27 neoplastic lesions and 56 non-neoplastic lesions), which constituted the study group. On contrast-enhanced sonography, mild enhancement and absence of contrast were more easily found in non-neoplastic lesions (12 [21.4%]), whereas all neoplastic lesions showed marked enhancement (27 [100%]; P = .006). Of the 27 neoplastic lesions, 6 malignant tumors showed a perfusion defect on contrast-enhanced sonography, whereas none of the non-neoplastic lesions showed a perfusion defect (P = .003). The microvascular architecture of the lesions was categorized into 4 types: spotty, linear, branched, and spinous, and there were significant differences between the groups (P< .001). In a kinetic evaluation, none of the parameters reached statistical significance (all P> .05). There was a discrepancy in maximum diameters between conventional and contrast-enhanced sonography in both groups but the discrepancy was significantly greater in the non-neoplastic group (P = .026).
  
  
  CONCLUSIONS
  Contrast-enhanced sonography is a useful imaging technique and an adjunct to conventional sonography for differential diagnosis of neoplastic and non-neoplastic polypoid lesions of the gallbladder.
authors.affiliation: Departments of Ultrasound (X.-S.L., L.-H.G., J.D., F.-H.L.) and Biliary and Pancreatic Surgery (J.W., T.C., Y.-H.Z.), Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Xue-Song
authors.initials: XS
authors.lastname: Liu
authors.affiliation: Departments of Ultrasound (X.-S.L., L.-H.G., J.D., F.-H.L.) and Biliary and Pancreatic Surgery (J.W., T.C., Y.-H.Z.), Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Li-Hong
authors.initials: LH
authors.lastname: Gu
authors.affiliation: Departments of Ultrasound (X.-S.L., L.-H.G., J.D., F.-H.L.) and Biliary and Pancreatic Surgery (J.W., T.C., Y.-H.Z.), Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Du
authors.affiliation: Departments of Ultrasound (X.-S.L., L.-H.G., J.D., F.-H.L.) and Biliary and Pancreatic Surgery (J.W., T.C., Y.-H.Z.), Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China. proflfh@163.com drjianw@163.com.
authors.forename: Feng-Hua
authors.initials: FH
authors.lastname: Li
authors.affiliation: Departments of Ultrasound (X.-S.L., L.-H.G., J.D., F.-H.L.) and Biliary and Pancreatic Surgery (J.W., T.C., Y.-H.Z.), Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Departments of Ultrasound (X.-S.L., L.-H.G., J.D., F.-H.L.) and Biliary and Pancreatic Surgery (J.W., T.C., Y.-H.Z.), Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Chen
authors.affiliation: Departments of Ultrasound (X.-S.L., L.-H.G., J.D., F.-H.L.) and Biliary and Pancreatic Surgery (J.W., T.C., Y.-H.Z.), Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Yun-He
authors.initials: YH
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging*; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D014463:Ultrasonography / Q000379:methods
chemical_list: D003287:Contrast Media
keywords: contrast-enhanced sonography; differential diagnosis; gallbladder; gastrointestinal ultrasound; polypoid lesion