Contrast-enhanced ultrasound in gallbladder disease: a pictorial review

Gerstenmaier, Jan; Hoang, Kimberly; Gibson, Robert N.

doi:10.1007/s00261-016-0729-4

Cited by 47 publications

(45 citation statements)

References 21 publications

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“…As sludge has no blood supply inside it, it shows a complete nonenhancement on both arterial phase and venous phase. The diagnostic accuracy was 100% in our study, and the result was similar with some previous studies[ 11 , 15 ].…”

Section: Discussionsupporting

confidence: 93%

Value of contrast-enhanced ultrasound in the differential diagnosis of gallbladder lesion

Zhang¹,

Bai²,

Gu³

et al. 2018

WJG

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AIMTo describe contrast-enhanced ultrasound (CEUS) features and evaluate differential diagnosis value of CEUS and conventional ultrasound for patients with benign and malignant gallbladder lesions.METHODSThis study included 105 gallbladder lesions. Before surgical resection and pathological examination, conventional ultrasound and CEUS were performed to examine for lesions. Then, all the lesions were diagnosed as (1) benign, (2) probably benign, (3) probably malignant or (4) malignant using both conventional ultrasound and CEUS. The CEUS features of these gallbladder lesions were analyzed and diagnostic efficiency between conventional ultrasound and CEUS was compared.RESULTSThere were total 17 cases of gallbladder cancer and 88 cases of benign lesion. Some gallbladder lesions had typical characteristics on CEUS (e.g., gallbladder adenomyomatosis had typical characteristics of small nonenhanced areas on CEUS). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CEUS were 94.1%, 95.5%, 80.0%, 98.8% and 95.2%, respectively. These were significantly higher than conventional ultrasound (82.4%, 89.8%, 60.9%, 96.3% and 88.6%, respectively). CEUS had an accuracy of 100% for gallbladder sludge and CEUS helped in differential diagnosis among gallbladder polyps, gallbladder adenoma and gallbladder cancer.CONCLUSIONCEUS may provide more useful information and improve the diagnosis efficiency for the diagnosis of gallbladder lesions than conventional ultrasound.

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Section: Discussionsupporting

confidence: 93%

Value of contrast-enhanced ultrasound in the differential diagnosis of gallbladder lesion

Zhang¹,

Bai²,

Gu³

et al. 2018

WJG

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“…CEUS is extensively applied in clinical practice and is the most well-developed method for liver imaging. [ 12 ] The Guidelines and Good Clinical Practice Recommendations for CEUS in the Liver (2012 edition) developed by the European Federation of Societies for Ultrasound in Medicine and Biology and World Federation for Ultrasound in Medicine and Biology [ 13 ] point out that the arterial phases of liver benign tumors mainly exhibit hyperenhancement, whereas the portal venous phases and delayed phases exhibit persistent hyperenhancement or iso-enhancement. The typical presentations of malignant tumors are rapid hyperenhancement in the arterial phases and hypoenhancement in the portal venous or delayed phases.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of liver tumors by multimodal ultrasound imaging

Zhou

Ran

et al. 2020

Medicine

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To investigate the diagnostic value of multimodal ultrasound imaging composed of conventional ultrasonography (US), contrast-enhanced ultrasonography (CEUS), and shear wave elastography (SWE) for liver tumors. Between October 2017 and October 2019, US, CEUS, and SWE examinations of a total of 158 liver tumors in 136 patients at The First Affiliated Hospital of Nanchang University were performed. The histopathological or imaging diagnostic results were used as controls to evaluate the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of US, CEUS, SWE, and multimodal ultrasound imaging, which combines these 3 modes, in the differential diagnosis of benign and malignant liver tumors. Among the 158 tumors, there were 64 benign tumors, including 55 cases of hepatic hemangioma, 3 cases of focal nodular hyperplasia of the liver, 4 cases of hepatic cyst, and 2 cases of focal nonuniform distribution of fat in the liver. There were 94 malignant tumors, including 32 cases of hepatocellular carcinoma, 22 cases of intrahepatic cholangiocellular carcinoma, 29 cases of metastatic liver cancer, and 11 cases of dysplastic nodules in cirrhotic liver. In the diagnosis of benign and malignant liver tumors, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 82.56%, 68.06%, 75.96%, 75.53%, and 76.56% for US; 92.39%, 86.36%, 89.87%, 90.43%, and 89.06% for CEUS; 87.14%, 76.81%, 82.91%, 82.98%, and 82.81% for SWE; and 97.85%, 95.38%, 96.83%, 96.81%, and 96.88% for multimodal ultrasound imaging, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were all significantly higher for multimodal ultrasound imaging than those values for US, CEUS, and SWE (all P < .05). The areas under the receiver operating characteristic curve for US, CEUS, SWE, and multimodal ultrasound imaging in the diagnosis of benign and malignant liver tumors were 0.760, 0.897, 0.829, and 0.968, respectively. US, CEUS, and SWE all have diagnostic value in the diagnosis of benign and malignant liver tumors. Multimodal ultrasound imaging could significantly increase the accuracy of the diagnosis of benign and malignant liver tumors and has higher value for clinical application.

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“…Previously there were several clinical studies on the application of CEUS in differentiating between benign and malignant gallbladder lesions. CEUS has been proved to be a sensitive and accurate diagnostic technique in clinical settings [10,[12][13][14]20,22,[25][26][27]. Compared with the liver, CEUS of the gallbladder shows a different hemodynamic behavior.…”

Section: Discussionmentioning

confidence: 99%

“…However, limitations of BMUS arise in several differentiating types of gallbladder lesions, such as motionless stiff sludge or ascariasis debris which can generate similar BMUS images with gallbladder tumors [10]. In some complicated cases, ascariasis debris will give a pseudotumorous appearance [4,11], which might lead to unnecessary operations [12,13]. A correct characterization of GB lesions is of importance to avoid unnecessary cholecystectomies and is helpful to clinical decision-making.…”

Section: Introductionmentioning

confidence: 99%

Differential diagnosis of gallbladder ascariasis debris: the added value of contrast enhanced ultrasound with high frequency transducer

et al. 2018

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Ascariasis debris of the gallbladder is a very rare incidental or symptomatic presentation. Ascaris debris has a pseudotumorous appearance and may be confused with neoplasia. The aim of the current retrospective study is to investigate the value of contrast enhanced ultrasound (CEUS) for the differential diagnosis of ascariasis debris and neoplasia of the gallbladder.Material and methods: Conventional B-mode ultrasound (BMUS) and CEUS were performed for solitary echo-rich gallbladder lesions. Analysis of the CEUS enhancement pattern of the lesions was conducted according to the current EFSUMB guidelines. Two radiologists assessed the CEUS enhancement patterns in consensus. The final gold standard was surgery with histological examination or imaging follow-up.Results: A total of 9 patients with final diagnoses of gallbladder ascariasis debris were included. As a control group 26 solitary hyperechoic gallbladder lesions without shadowing were included as a control group. The typical zigzag morphology with multiple echogenic parallel lines without shadow were detected inside the lumen of the gallbladder in 6 patients. After injection of 2.4 ml ultrasound contrast agents, all hyperechoic gallbladder ascariasis debris lesions showed no enhancement. All patients in the control group with similar BMUS morphology showed contrast enhancement.Conclusions: Real time visualization of contrast enhancement without radiation exposure is one of the main advantages of CEUS over other diagnostic modalities to differentiate ascariasis debris in the gallbladder from enhancing neoplasia. Thus, surgery and other interventions and their complications could be avoided.

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Contrast-enhanced ultrasound in gallbladder disease: a pictorial review

Cited by 47 publications

References 21 publications

Value of contrast-enhanced ultrasound in the differential diagnosis of gallbladder lesion

Value of contrast-enhanced ultrasound in the differential diagnosis of gallbladder lesion

Diagnosis of liver tumors by multimodal ultrasound imaging

Differential diagnosis of gallbladder ascariasis debris: the added value of contrast enhanced ultrasound with high frequency transducer

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