High-resolution sonography for distinguishing neoplastic gallbladder polyps and staging gallbladder cancer
| Autor: | Joon Koo Han, Byung I. Choi, Jung Hoon Kim, Young Jeon Kim, Hyo Won Eun, Jae Young Lee, Jee H.yun Baek |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty High resolution Diagnostic accuracy Gallbladder Diseases Diagnosis Differential McNemar's test Polyps Gallbladder polyp medicine Humans Radiology Nuclear Medicine and imaging Gallbladder cancer Aged Neoplasm Staging Retrospective Studies Ultrasonography Aged 80 and over business.industry Gallbladder T category Reproducibility of Results Retrospective cohort study General Medicine Middle Aged medicine.disease medicine.anatomical_structure Female Gallbladder Neoplasms Radiology business |
| Zdroj: | AJR. American journal of roentgenology. 204(2) |
| ISSN: | 1546-3141 |
| Popis: | OBJECTIVE. The purposes of this study were to compare staging accuracy of high-resolution sonography (HRUS) with combined low- and high-MHz transducers with that of conventional sonography for gallbladder cancer and to investigate the differences in the imaging findings of neoplastic and nonneoplastic gallbladder polyps. MATERIALS AND METHODS. Our study included 37 surgically proven gallbladder cancer (T1a = 7, T1b = 2, T2 = 22, T3 = 6), including 15 malignant neoplastic polyps and 73 surgically proven polyps (neoplastic = 31, nonneoplastic = 42) that underwent HRUS and conventional transabdominal sonography. Two radiologists assessed T-category and predefined polyp findings on HRUS and conventional transabdominal sonography. Statistical analyses were performed using chi-square and McNemar tests. RESULTS. The diagnostic accuracy for the T category was T1a = 92-95%, T1b = 89-95%, T2 = 78-86%, and T3 = 84-89%, all with good agreement (κ = 0.642) using HRUS. The diagnostic accuracy for differentiating T1 from T2 or greater than T2 was 92% and 89% on HRUS and 65% and 70% with conventional transabdominal sonography. Statistically common findings for neoplastic polyps included size greater than 1 cm, single lobular surface, vascular core, hypoechoic polyp, and hypoechoic foci (p0.05). The value of HRUS in the differential diagnosis of a gallbladder polyp was more clearly depicted internal echo foci than conventional transabdominal sonography (39 vs 21). A polyp size greater than 1 cm was independently associated with a neoplastic polyp (odds ratio = 7.5, p = 0.02). The AUC of a polyp size greater than 1 cm was 0.877. The sensitivity and specificity were 66.67% and 89.13%, respectively. CONCLUSION. HRUS is a simple method that enables accurate T categorization of gallbladder carcinoma. It provides high-resolution images of gallbladder polyps and may have a role in stratifying the risk for malignancy. |
| Databáze: | OpenAIRE |
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