To assess the value of conventional ultrasound in the differential diagnosis of cholesterol polyp lesions and gallbladder adenomas with the maximum size from 1.0 to 1.5 cm.

From May 2019 to October 2020, the clinical data of 87 patients with gallbladder polyp lesions with the maximum size from 1.0 to 1.5 cm at the First Medical Center, Chinese PLA General Hospital were retrospectively analyzed. All patients underwent conventional ultrasound examination and pathological examination. According to the pathological findings, all patients were divided into either a cholesterol polyp lesion group or a gallbladder adenoma group. Patient age, gender, maximum size, anteroposterior/transverse diameter (A/T) ratio, stalk width, location, echogenicity, echogenicity uniformity, boundary, number, hyperechoic spot, blood flow signal, and gallstones were compared between the two groups. Logistic regression analysis was performed to identify the independent risk factors for gallbladder adenomas. ROC curve was used to evaluate the performance of conventional ultrasound in the diagnosis of gallbladder adenomas with the maximum size from 1.0 to 1.5 cm.

Among the 87 patients with gallbladder polyp lesions, 65 had cholesterol polyp lesions and 22 had gallbladder adenomas. The maximum size, A/T ratio, percentage of lesions with hyperechoic spot, percentage of lesions with blood flow signal, and percentage of lesions with gallstones differed significantly between the cholesterol polyp lesion group and gallbladder adenoma group [ 1.2 (1.1, 1.3) cm vs 1.2 (1.1, 1.4) cm, Z=-2.048, P＜0.05; 1.0 (0.7, 1.5) vs 0.6 (0.5, 0.7), Z=-3.396, P＜0.05; 73.85% vs 22.73%, χ²=18.041, P＜0.05; 9.23% vs 54.55%, χ²=20.569, P＜0.05; 3.08% vs 18.18%, χ²=5.841, P＜0.05]. Logistic regression analysis showed that only the A/T ratio less than 0.8, absence of hyperechoic spot, and presence of blood flow signal were independent risk factors for gallbladder adenomas (P＜0.05). When combining all independent risk factors, the sensitivity, specificity, and accuracy of conventional ultrasound in diagnosing gallbladder adenomas with the maximum size from 1.0 to 1.5 cm were 86.36%, 90.77%, and 89.66%, respectively, and the area under the ROC curve was 0.906. The area under the ROC curve of the risk factors combined was larger than that of either ultrasound feature alone (P＜0.05).

A/T ratio, hyperechoic spot, and blood flow signal of gallbladder polyp lesions on conventional ultrasound images have high application value in the differential diagnosis of cholesterol polyp lesions and gallbladder adenomas with the maximum size from 1.0 to 1.5 cm, which provides reliable diagnostic information for the choice of treatment for patients with gallbladder polyp lesions.