التفاصيل البيبلوغرافية
العنوان: |
CEUS in the differential diagnosis between biliary sludge, benign lesions and malignant lesions. |
المؤلفون: |
Serra, Carla, Felicani, Cristina, Mazzotta, Elena, Gabusi, Veronica, Grasso, Valentina, De Cinque, Antonio, Giannitrapani, Lydia, Soresi, Maurizio |
المصدر: |
Journal of Ultrasound; Jun2018, Vol. 21 Issue 2, p119-126, 8p |
مستخلص: |
Purpose: Conventional grayscale ultrasound (US) is accurate in the diagnosis of gallbladder disease (GD), but in some cases, it is not decisive. Contrast-enhanced ultrasound (CEUS) improves the diagnostic accuracy of US. The primary objective of this study is to assess the reliability of CEUS in the diagnosis of sludge; the secondary objective is to assess the ability of CEUS to diagnose cancer.Methods: We retrospectively reviewed the US of 4137 patients positive for GD. In 43/4137 (1.04%), the use of could not discriminate between sludge and neoplasms. Then, we evaluated CEUS in only 39 of these patients, and in 4/43 (9%) cases it was not performable. After CEUS, the absence of enhancement was considered diagnostic for sludge, while contrast washout within 60 s diagnosed malignant lesions.Results: Among the 39 patients, 16 had biliary sludge and 23 had lesions of the gallbladder wall; 9 of these were carcinomas and 14 were benign tumors. The absence of enhancement was present in 16/16 patients with sludge and in 0/23 patients with lesions of the gallbladder (sensitivity and specificity 100%). Washout was within 60 s in 9/9 gallbladder carcinomas and 2/14 benign lesions (sensitivity 100%; specificity 85%).Conclusions: US is confirmed to be accurate in the diagnosis of GD. In doubtful cases, CEUS is very accurate in biliary sludge diagnosis. An intralesional washout at 60 s is a pattern of malignancy that can orient towards a correct diagnosis, but it is limited by the presence of false positive results, especially for smaller lesions. [ABSTRACT FROM AUTHOR] |
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