Contrast-Enhanced Ultrasound in the Diagnosis of Gallbladder Diseases: A Multi-Center ExperienceReportar como inadecuado




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Objective

To assess the usefulness of contrast–enhanced ultrasound CEUS in differentiating malignant from benign gallbladder GB diseases.

Methods

This study had institutional review board approval. 192 patients with GB diseases from 9 university hospitals were studied. After intravenous bonus injection of a phospholipid-stabilized shell microbubble contrast agent, lesions were scanned with low acoustic power CEUS. A multiple logistic regression analysis was performed to identify diagnostic clues from 17 independent variables that enabled differentiation between malignant and benign GB diseases. Receiver operating characteristic ROC curve analysis was performed.

Results

Among the 17 independent variables, multiple logistic regression analysis showed that the following 4 independent variables were associated with the benign nature of the GB diseases, including the patient age, intralesional blood vessel depicted on CEUS, contrast washout time, and wall intactness depicted on CEUS all P<0.05. ROC analysis showed that the patient age, intralesional vessels on CEUS, and the intactness of the GB wall depicted on CEUS yielded an area under the ROC curve Az greater than 0.8 in each and Az for the combination of the 4 significant independent variables was 0.915 95% confidence interval CI: 0.857–0.974. The corresponding Az, sensitivity, and specificity for the age were 0.805 95% CI: 0.746–0.863, 92.2%%, and 59.6%; for the intralesional vessels on CEUS were 0.813 95% CI: 0.751–0.875, 59.8%, and 98.0%; and for the GB wall intactness were 0.857 95% CI: 0.786–0.928, 78.4%, and 92.9%. The cut-off values for benign GB diseases were patient age <53.5 yrs, dotted intralesional vessels on CEUS and intact GB wall on CEUS.

Conclusion

CEUS is valuable in differentiating malignant from benign GB diseases. Branched or linear intralesional vessels and destruction of GB wall on CEUS are the CEUS features highly suggestive of GB malignancy and the patient age >53.5 yrs is also a clue for GB malignancy.



Autor: Lin-Na Liu, Hui-Xiong Xu , Ming-De Lu , Xiao-Yan Xie, Wen-Ping Wang, Bing Hu, Kun Yan, Hong Ding, Shao-Shan Tang, Lin-Xue Qian, B

Fuente: http://plos.srce.hr/



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