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Differential diagnosis between gallbladder adenomas and cholesterol polyps on contrast-enhanced harmonic endoscopic ultrasonography

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Abstract

Background

Differential diagnosis between gallbladder (GB) adenomas and cholesterol polyps based on ultrasonography or endoscopic ultrasonography (EUS) is challenging because they have similar echogenicity and morphology. We evaluated the usefulness of contrast-enhanced harmonic EUS (CEH-EUS) for differentiating between GB adenomas and cholesterol polyps.

Methods

Between June 2010 and December 2011, a total of 87 patients with GB polyps who underwent a CEH-EUS were reviewed retrospectively.

Results

Of the 87 patients, 57 had a cholecystectomy. Of these, 34 patients were diagnosed with adenoma, cholesterol polyp, adenocarcinoma, or adenomyomatosis pathology. The remaining 23 patients were not diagnosed with GB polyps because their lesions separated from the GB mucosal layer during pathological sampling. On CEH-EUS, homogeneous and heterogeneous enhancement was shown in 6 and 2 patients with adenoma and in 4 and 8 patients with cholesterol polyps, respectively. Sensitivity and specificity of CEH-EUS for differential diagnosis of GB adenomas from cholesterol polyps based on the enhancement pattern were 75.0 and 66.6 %, respectively.

Conclusion

CEH-EUS might be useful for distinguishing GB adenomas and cholesterol polyps based on enhancement patterns. However, an additional technique such as quantitative perfusion analysis is necessary because visual assessment of CEH-EUS images is subjective.

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Disclosures

Chan Hyuk Park, Moon Jae Chung, Tak Geun Oh, Jeong Youp Park, Seungmin Bang, Seung Woo Park, Hyunki Kim, Ho Kyoung Hwang, Woo Jung Lee, and Si Young Song have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Division of Gastroenterology, Yonsei Institute of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea

    Chan Hyuk Park, Moon Jae Chung, Tak Geun Oh, Jeong Youp Park, Seungmin Bang, Seung Woo Park & Si Young Song

  2. Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea

    Hyunki Kim

  3. Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea

    Ho Kyoung Hwang & Woo Jung Lee

  4. Brain Korea 21 Project for Medical Science, Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea

    Si Young Song

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  1. Chan Hyuk Park
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  2. Moon Jae Chung
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Corresponding author

Correspondence to Moon Jae Chung.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Video 1 Video clip of gallbladder adenoma on CEH-EUS (MPG 10256 kb)

Video 2 Video clip of gallbladder cholesterol polyp on CEH-EUS (MPG 10256 kb)

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Park, C.H., Chung, M.J., Oh, T.G. et al. Differential diagnosis between gallbladder adenomas and cholesterol polyps on contrast-enhanced harmonic endoscopic ultrasonography. Surg Endosc 27, 1414–1421 (2013). https://doi.org/10.1007/s00464-012-2620-x

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  • DOI: https://doi.org/10.1007/s00464-012-2620-x

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