Differentiation of Adenomyomatosis of the Gallbladder from Early-stage, Wall-thickening-type Gallbladder Cancer Using High-resolution Ultrasound

Joo I, Lee JY, Kim JH, Kim SJ, Kim MA, Han JK, Choi BI

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?

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.