Value of contrast-enhanced ultrasound in the differential diagnosis between gallbladder adenoma and gallbladder adenoma canceration.

OBJECTIVES To investigate the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis between gallbladder adenomas and gallbladder adenomas canceration. METHODS CEUS data from 34 patients (25 patients with gallbladder adenomas and 9 patients with gallbladder adenomas canceration) were retrospectively analyzed, including the characteristics of contrast arrival time, time to peak enhancement, enhancement extend, enhancement morphology and the intactness of gallbladder wall below the lesions. RESULTS On CEIS, the contrast arrival time and the time to peak enhancement were significantly shorter in patients with gallbladder adenomas than in patients with gallbladder adenomas canceration (12.63 ± 3.37 s vs. 18.11 ± 3.26 s, P < 0.001; 17.42 ± 3.69 s vs. 24.56 ± 4.36 s, P < 0.001). The time to iso-enhancement showed no significant difference between the two groups; while the time to hypo-enhancement was significantly shorter in patients with gallbladder adenomas canceration than in patients with gallbladder adenomas (55.56 ± 15.48 s vs. 84.71 ± 36.07 s, P = 0.027), and the enhancement time of the liver was significantly slower in patients with gallbladder adenomas canceration than in patients with gallbladder adenomas (22.78 ± 5.28 s vs. 16.63 ± 4.66 s, P = 0.004). Using receiver operating characteristic (ROC) analysis, the time to peak enhancement greater than 20 s had 89% sensitivity and 84% specificity for detecting patients with gallbladder adenomas canceration. The enhancement level showed no difference between the two groups. Inhomogeneous enhancement was found in 33% (3/9) gallbladder adenoma canceration and none (0/25) of gallbladder adenoma (P < 0.01). Destruction of gallbladder wall intactness was found in 66.7% (6/9) gallbladder adenoma canceration and none (0/25) of gallbladder adenoma (P < 0.01). CONCLUSION CEUS is useful in differentiation between gallbladder adenoma and gallbladder adenoma canceration. The time to peak enhancement, the enhancement morphology and the intactness of gallbladder wall below the lesions are the diagnostic clues in differentiating diagnosis between gallbladder adenoma and gallbladder adenoma canceration.