Clinical application of high-frame-rate contrast-enhanced ultrasound in distinguishing gallbladder adenomas from cholesterol polyps

doi:10.3877/cma.j.issn.1672-6448.2020.09.001

Abstract

Abstract:

Objective

To compare the diagnostic value of conventional contrast-enhanced ultrasound (CEUS) and high-frame-rate CEUS (H-CEUS) in differentiating gallbladder adenomas from cholesterol polyps.

Methods

Sixty-five patients who underwent laparoscopic cholecystectomy for gallbladder polypoid lesions (GPL) at the First Medical Centre of Chinese PLA General Hospital from August 2019 to February 2020 were collected. Pre-operative CEUS and H-CEUS were performed in all patients. According to the pathological results, the patients were divided into either an adenoma group (16 cases) or a cholesterol polyp group (49 cases). The perfusion characteristics of the lesions and the final diagnosis were compared between the two methods and between CEUS and H-CEUS. The χ² test was used to compare the differences in vascular morphology, enhancement intensity, and gallbladder wall integrity between the two groups.

Results

CEUS had no statistical difference in judging the vascular morphology of gallbladder adenomas and cholesterol polyps (P>0.05). CEUS observed that 85.71% (42/49) of cholesterol polyps and 68.75% (11/16) of gallbladder adenomas showed uniform spot vascular structures. H-CEUS can significantly judge the difference in vascular morphology between gallbladder adenomas and cholesterol polyps (χ²=26.527, P<0.001). H-CEUS observed that 75.51% (37/49) of cholesterol polyps and 25.00% (4/16) of adenomas showed uniform spot vascular structures. There was no difference in the vascular morphology between CEUS and H-CEUS in the cholesteric polyp group (P>0.05), while the vascular morphology between CEUS and H-CEUS in the adenoma group was statistically different (χ²=7.878, P=0.019). In the adenoma group, CEUS can only detect 6.25% (1/16) of the branch vessel morphologies, while H-CEUS can detect 43.75% (4/16) of the branch vessel morphologies.

Conclusion

H-CEUS improves the temporal resolution by increasing the frame rate, which helps to accurately reflect the differences of GPL microcirculation and improves the differential diagnosis of cholesterol polyps and adenomas. In the selection of treatment plans, H-CEUS provides an effective imaging examination method for GPL patients.

Key words: Contrast-enhanced ultrasound, Gallbladder polyp lesion, Gallbladder adenoma, Cholesterol polyp

Peng Han, Xiang Fei, Yukun Luo, Lianhua Zhu, Wenbo Tang. Clinical application of high-frame-rate contrast-enhanced ultrasound in distinguishing gallbladder adenomas from cholesterol polyps[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(09): 815-820.

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Figures/Tables 4

References 21

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组别	例数	年龄（岁，±s）	性别（男/女）	最大径（cm，±s）	回声特征（例）			数量（例）		血流信号（例）
组别	例数	年龄（岁，±s）	性别（男/女）	最大径（cm，±s）	高回声	等回声	低回声	单发	多发	有	无
胆固醇性息肉组	49	41.45±1.65	20/29	1.13±0.12	41	8	0	40	9	3	46
腺瘤性息肉组	16	45.37±3.42	11/5	1.57±0.14	9	6	1	13	3	14	2
统计值	?	t=1.456	χ²=3.773	t=9.173	χ²=6.974			χ²=0.001		χ²=41.357
P值	?	0.135	0.052	<0.001	0.031			0.973		<0.001

组别	例数	年龄（岁，±s）	性别（男/女）	最大径（cm，±s）	回声特征（例）			数量（例）		血流信号（例）
组别	例数	年龄（岁，±s）	性别（男/女）	最大径（cm，±s）	高回声	等回声	低回声	单发	多发	有	无
胆固醇性息肉组	49	41.45±1.65	20/29	1.13±0.12	41	8	0	40	9	3	46
腺瘤性息肉组	16	45.37±3.42	11/5	1.57±0.14	9	6	1	13	3	14	2
统计值	?	t=1.456	χ²=3.773	t=9.173	χ²=6.974			χ²=0.001		χ²=41.357
P值	?	0.135	0.052	<0.001	0.031			0.973		<0.001

检查方法	组别	例数	血管形态			增强强度		胆囊壁完整性
检查方法	组别	例数	点状	单支样	分支样	高增强	非高增强	完整	缺损
CEUS	胆固醇性息肉组	49	42	7	0	2	47	49	0
?	腺瘤性息肉组	16	11	4	1	11	5	13	3
?	χ²值	?	4.306			31.526		9.632
?	P值	?	0.116			<0.001		0.002
H-CEUS	胆固醇性息肉组	49	37	12	0	1	48	49	0
?	腺瘤性息肉组	16	4	5	7	15	1	13	3
?	χ²值	?	26.527			54.669		9.632
?	P值	?	<0.001			<0.001		0.002
χ²值^a	?	?	1.632			0.344		0.000
P值^a	?	?	0.201			0.558		1.000
χ²值^b	?	?	7.878			3.282		0.000
P值^b	?	?	0.019			0.070		1.000

检查方法	组别	例数	血管形态			增强强度		胆囊壁完整性
检查方法	组别	例数	点状	单支样	分支样	高增强	非高增强	完整	缺损
CEUS	胆固醇性息肉组	49	42	7	0	2	47	49	0
?	腺瘤性息肉组	16	11	4	1	11	5	13	3
?	χ²值	?	4.306			31.526		9.632
?	P值	?	0.116			<0.001		0.002
H-CEUS	胆固醇性息肉组	49	37	12	0	1	48	49	0
?	腺瘤性息肉组	16	4	5	7	15	1	13	3
?	χ²值	?	26.527			54.669		9.632
?	P值	?	<0.001			<0.001		0.002
χ²值^a	?	?	1.632			0.344		0.000
P值^a	?	?	0.201			0.558		1.000
χ²值^b	?	?	7.878			3.282		0.000
P值^b	?	?	0.019			0.070		1.000

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