To investigate the contrast enhanced ultrasound (CEUS) characteristics of thickened wall type of gallbladder carcinoma and to evaluate their diagnostic value.

The CEUS images, clinical information and pathological results of 26 patients with thickened wall type of gallbladder carcinoma and 37 patients having benign gallbladder disease with thickened wall were retrospectively analyzed. CEUS characteristics of thickened wall type of gallbladder carcinoma were investigated and their diagnostic value was evaluated. The age, length of gallbladder, width and thickness of gallbladder wall were analyzed by t test. The CEUS characteristics of gallbladder wall (intensity of gallbladder wall, mucosal morphology and submucosal hypo-enhancement area) were analyzed by χ² test. The diagnostic test used ROC (receiver operating characteristic) curve to calculate sensitivity, specificity, positive predictive value, negative predictive value and accuracy.

The gallbladder wall thickness and patient age in malignant group were all larger than those in benign group [(1.63±0.68) cm vs (0.96±0.55) cm, (63.7±10.1) years old vs (53.2±11.8) years old], with statistically significant difference (t=3.70, 4.32, all P<0.001). In the malignant group, CEUS showed irregular mucosal, hyper-enhancement and sub-mucosal hypo-enhancement area, with statistically significant difference (χ²=48.7, 42.9, 23.8, OR=9.25, 6.17, 2.47, all P<0.001). The sensitivity of irregular mucosa, hyper-enhancement and sub-mucosal hypo-enhancement area were all 100.0%, and their accuracy were 93.7%, 90.5% and 76.2% respectively. If lesions with both irregular mucosa and hyper-enhancement were diagnosed as thickened wall type of gallbladder carcinoma, the diagnostic accuracy could be further improved to 98.4%.

CEUS can facilitate the differential diagnosis of benign and malignant gallbladder diseases with thickened wall in a high diagnostic value.