To analyze the quality of ultrasound report and the causes of misdiagnosis of xanthogranulomatous cholecystitis (XGC), and to explore the measures to improve the ultrasound diagnosis accuracy of XGC.

From January 2015 to March 2020, the patients diagnosed with XGC by pathology at Peking Union Medical College Hospital were reviewed. There were 51 cases of XGC, including 27 males and 24 females, with an average age of 53.6±21.5 years. The description, diagnosis, and seniority of the examiner in the preoperative ultrasound report were analyzed. Chi-square test was used to compare the differences in the description grade and the diagnosis grade between different seniority groups.

Forty-seven (92.2%) cases had "complete description" and four (7.8%) had "incomplete description". The ultrasonic diagnosis results of 40 (78.4%) cases were classified as "consistent", and 11 (21.6%) classified as "inconsistent", among which 9 (17.6%) were misdiagnosed as malignant lesions of the gallbladder and 2 (3.9%) as adenomyosis of the gallbladder. Of the 51 ultrasound examiners involved, 28 had junior title, 6 had intermediate title, and 17 had senior title. There was no significant difference in ultrasonic description and diagnosis grades between examiners with different seniority (P>0.05).

It is difficult to diagnose XGC by ultrasound before operation. Ultrasound doctors should be familiar with the characteristics of ultrasound image. If necessary, they can improve the quality of ultrasound diagnosis by means of consultation and new ultrasonic technologies.