Application of contrast-enhanced ultrasound and enhancement patterns in the diagnosis of gallbladder cancer

Objective To investigate the clinical value of contrast-enhanced ultrasound(CEUS) in the diagnosis of gallbladder cancer.Methods Twenty patients with gallbladder cancer and thirty-seven patients with benign gallbladder disease underwent conventional ultrasound and real-time CEUS.The enhancement patterns including types of time-intensity curve,centripetal fill-in,homogeneity and intensity of enhancement were analyzed.Results The focus and gallbladder wall in gallbladder cancers were enhanced at the same time,hepatic artery phase was mainly highly enhanced,hepatic portal vein phase was mairdy lowly enhanced.The percentages of those lesions that exhibited hyper-enhancement or iso-enhancement in the early phase and turned to hypo-enhancement within 35 s after contrast agent administration were 95.0%(19 /20) in gallbladder cancers and 16.2%(6 /37) in benign lesions(P = 0.000).Inhomogeneous enhancement was found 80.0%(16 /20) in gallbladder cancers and 23.3%(7 /30) in benign lesions (P =0.000).Destruction of the integrality of gallbladder wall was found 85.0%(17/20) in gallbladder cancers and none(0.0%,0 /37) in benign lesions(P = 0.000).The diagnose accordance rate、sensitivity and specificity of benign and malignant gallbladder diseases by CEUS was were 92.98% 、95.00% and91.83%,respectively.Conclusion CEUS can improve the diagnosis rates of gallbladder cancer and the ability of differentiating diagnosis between benign and malignant gallbladder diseases compared with conventional ultrasound.