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European Radiology
Published in: European Radiology 3/2013

01-03-2013 | Gastrointestinal

Differentiation of adenomyomatosis of the gallbladder from early-stage, wall-thickening-type gallbladder cancer using high-resolution ultrasound

Authors: Ijin Joo, Jae Young Lee, Jung Hoon Kim, Soo Jin Kim, Min A. Kim, Joon Koo Han, Byung Ihn Choi

Published in: European Radiology | Issue 3/2013

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Abstract

Objectives

To evaluate the diagnostic performance of transabdominal high-resolution ultrasound (HRUS) for differentiation of adenomyomatosis from early-stage, wall-thickening-type gallbladder (GB) cancer.

Methods

HRUS was defined as the addition of high megahertz imaging to conventional low megahertz imaging with use of state-of-the-art imaging technology. HRUS findings were retrospectively compared in 45 patients with adenomyomatosis and 28 patients with stage T1/T2 wall-thickening-type GB cancer. For evaluating HRUS performance in the differential diagnosis of adenomyomatosis from GB cancer, receiver operating characteristic curve analysis was used with a five-point confidence scale independently scored by three blinded radiologists who also analysed morphological abnormalities.

Results

The area under the receiver operating characteristic curve (A z) values of HRUS in the diagnosis of adenomyomatosis were 0.948, 0.915 and 0.917 for reviewers 1, 2 and 3. Symmetrical wall thickening, intramural cystic spaces, intramural echogenic foci and twinkling artefacts were significantly associated with adenomyomatosis (P < 0.05), whereas irregular thickening of the outer wall, focal innermost hyperechoic layer (IHL) discontinuity, IHL irregularity, IHL thickening greater than 1 mm, loss of multilayer pattern in the GB wall, and intralesional vascularity were significantly associated with cancer (P < 0.05). The sensitivity, specificity and accuracy of intramural cystic spaces/echogenic foci for the diagnosis of adenomyomatosis were 80.0 %, 85.7 % and 82.2 %.

Conclusions

This study showed that HRUS can be helpful for distinguishing adenomyomatosis from early-stage, wall-thickening-type GB cancer.

Key Points

• Transabdominal high-resolution ultrasound (HRUS) helps differentiate adenomyomatosis from gallbladder cancer.
• HRUS can evaluate the detailed anatomy of the gallbladder wall.
• Adenomyomatosis of the gallbladder shows characteristic findings on HRUS.
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Metadata
Title
Differentiation of adenomyomatosis of the gallbladder from early-stage, wall-thickening-type gallbladder cancer using high-resolution ultrasound
Authors
Ijin Joo
Jae Young Lee
Jung Hoon Kim
Soo Jin Kim
Min A. Kim
Joon Koo Han
Byung Ihn Choi
Publication date
01-03-2013
Publisher
Springer-Verlag
Published in
European Radiology / Issue 3/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2641-9

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