Evaluation of gallbladder and biliary duct disease using microbubble contrast-enhanced ultrasound

Abstract

ABSTRACT. Ultrasound examination of the gallbladder is accepted as the primary imaging modality in the assessment of gallbladder disease, with inherent superiority in comparison to other imaging modalities. Contrast-enhanced ultrasound is established as a reliable tool in the detection and characterisation of focal liver lesions. It is less well recognised in gallbladder and biliary disease but can be a valuable complement to baseline ultrasound examination. Contrast-enhanced ultrasound provides the advantages of real-time, repeatable, multiplanar imaging without compromising patient safety or exposing patients to radiation. It can provide specific information as pathology often becomes more conspicuous following the administration of contrast, allowing detailed assessment of benign and malignant conditions arising in the gallbladder and biliary tree. This review illustrates the application of contrast-enhanced ultrasound in the evaluation of a variety of gallbladder and biliary duct diseases. The examination allows clearer delineation of the disease process and more confident diagnosis.

Contrast-enhanced ultrasound may distinguish gallbladder adenoma from cholesterol polyps: a prospective case–control study

“…CEUS is able to overcome such disadvantages of standard US. The enhancing gallbladder wall and stalk of polyps were better visualized during the arterial phase because the cystic artery and gallbladder wall enhance earlier than the adjacent liver parenchyma [26]. In our study, the stalk width of cholesterol polyps was significantly smaller than that of adenomas.…”

“…Choosing an appropriate treatment for patients with GPL greatly depends on accurate diagnosis and physicians often make the diagnosis according to information obtained from radiological imaging [3]. Ultrasonography is the most widely used imaging modality for the diagnosis of gallbladder disease, but it is difficult to distinguish adenoma from benign cholesterol polyp on the basis of standard ultrasonographic features [26]. Several studies report that the polyp size larger than 10 mm is not only a useful discriminator but also a risk factor indicating for cholecystectomy in treatment algorithm [3,9,27].…”

Role of contrast enhanced ultrasound in the assessment of biliary duct disease

“…On conventional US, this tumour may be infiltrative, exophytic or polypoid. Due to the isoechoic appearance, respectively infiltrative pattern of growth, the detection of the tumour with its delineating border is sometimes extremely difficult, especially for an inexperienced examiner [6,11,12].…”

“…On CEUS examination during the arterial phase, the tumour can appear either with peripheral irregular rimlike hyperenhancement, or as a diffuse heterogeneous hyperenhancement [12]. As enhancement the tumours are hyper-enhanced, isoenhanced and hypo-enhanced in 43.8%, 43.8%, and 12.4% of cases [6].…”

Application of Contrast‐Enhanced Sonography for Diagnosis of Space‐Occupying Lesions in the Extrahepatic Bile Duct

“…[3][4][5][6] However, there are limited studies of the application of ultrasound contrast agents for imaging space-occupying lesions in the extrahepatic bile duct, and the technique has not been widely recognized in clinical practice. 7,8 In this article, the application of conventional and contrastenhanced sonography compared with contrast-enhanced computed tomography (CT) for diagnosis of spaceoccupying lesions in the extrahepatic bile duct is summarized on the basis of our departmental experience, and the clinical applications of these techniques are discussed.…”