Clinical application research of contrast-enhanced ultrasound in differential diagnosis between benign and malignant gallbladder disease

Objective To discuss the blood perfusion characteristic of benign and malignant gallbladder disease by contrast-enhanced ultrasound(CEUS). Methods The enhancement characteristic of 62 patients with occupying lesions in gallbladder were observed. Four case of cholecystolithiasis accompany biliary sludge were proven by surgery and remaining 58 case were confirmed by histopathological examination. Their enhancement time and enhancement pattern were analyzed. Results The Time-to-peak of benign and malignant disease were (22.4±4.0)s and (27.7±2.6)s (t=5.756, P<0.01), the Time-to-hypoenhancement of benign and malignant disease were (58.0±7.3)s and (41.5±4.0)s (t=10.33, P<0.01), respectively. The peak intensity of benign and malignant disease were (19.2±3.6)dB and (25.1±2.9)dB (t=6.85, P<0.01), the mean transit time of benign and malignant disease were (22.72±4.7)s and (6.3±6.4)s (t=15.001, P<0.01), respectively. The destruction of the gallbladder wall of benign and malignant disease were 0%(0/36) and 57.7%(15/26) (χ2=25.05, P<0.01), the inhomogeneous enhancement of benign except biliary sludge and malignant disease were 43.8%(14/32) and 57.7%(15/26) (χ2=1.115, P=0.291, respectively). In early phase, 78.1%(25/32)and 80.8%(21/26) of benign disease except biliary sludge and malignant showed hyperenhancement respectively(χ2=3.15, P=0.207). In later phase, 84.4%(27/32) and 76.9%(20/26) of benign disease except biliary sludge and malignant showed hypoenhancement respectively(χ2=3.615, P=0.164). Conclusions CEUS can obtain the information of blood perfusion and make quantitatively analysis about the enhancement time.It also facilitate the diagnosis of solid occupying lesion in gallbladder. Key words: Ultrasonography; Microbubbles; Gallbladder disease