CT biliary cystoscopy of gallbladder polyps

Abstract

AIM:CT virtual endoscopy has been used in the study of various organs of body including the biliary tract, however, CT virtual endoseopy in diagnosis of gallbladder polyps has not yet been reported. This study was to evaluate the diagnostic value of CT virtual endoscopy in polyps of the gallbladder. METHODS:Thirty-two cases of gallbladder polyps were examined by CT virtual endoscopy, ultrasound, CT scan with oral biliary contrast separately and confirmed by operation and pathology. CT biliary cystoscopic findings were analyzed and compared with those of ultrasound and CT scan with oral biliary contrast, and evaluated in comparison with operative and pathologic findings in all cases. RESULTS:The detection rate of gallbladder polyps was 93.8%(90/96), 96.9%(93/96) and 79.2%(76/96) for CT cystoscopy, ultrasound and CT scan with oral contrast, respectively. CT biliary cystoscopy corresponded well with ultrasound as well as pathology in demonstrating the location, size and configuration of polyps. CT endoscopy was superior to ultrasound in viewing the polyps in a more precise way, 3 dimensionally from any angle in space, and showing the surface in details. CT biliary cystoscopy was also superior to CT scan with oral biliary contrast in terms of observation of the base of polyps for the presence of a pedicle, detection rates as well as image quality. The smallest polyp detected by CT biliary cystoscopy was measured 1.5 mm×2.2 mm×2.5 mm. CONCLUSION:CT biliary cystoscopy is a non-invasive and accurate technique for diagnosis and management of gallbladder polyps.

AGA Clinical Practice Update on Surveillance for Hepatobiliary Cancers in Patients With Primary Sclerosing Cholangitis: Expert Review

“…47 A single study found that CT scans with oral contrast detected only 76 of 96 (79.2%) surgically confirmed gallbladder polyps, although all missed lesions were smaller than 5 mm. 48 There are no data on the ability of MRI to identify gallbladder polyps.…”

Current practices and future prospects for the management of gallbladder polyps: A topical review

“…The CT diagnosis was accurate in 87% of cases however, only 5 polyps were less than 11 mm and therefore this study provides us with limited evidence regarding the role of CT in this group of patients[ 35 ]. Lou et al[ 36 ] assessed the accuracy of CT biliary cystoscopy in 32 patients and found that CUS accurately detected polyps in 96.9% of cases compared to 93.8% for CT.…”

The Correlation between Ultrasonography and Histopathology in the Management of Gall Bladder Polyps

“…Alternatively, nonenhanced and enhanced CT scan differentiate neoplastic from non-neoplastic gall bladder polyps (12). CT biliary cystoscopy has recently been suggested as a non-invasive and accurate means of assessing gall bladder polyps (13). However, in most of the units it may not be logistically practical and financially feasible to perform EUS or CT purely to differentiate gallbladder polyps.…”