[Differential diagnosis of gallbladder polypoid lesions by micro-flow imaging].

Zhu L, Han P, Jiang B, Li N, Fei X
Nan fang yi ke da xue xue bao = Journal of Southern Medical University · 2022 · doi:10.12122/j.issn.1673-4254.2022.06.17 · PMID:35790444 · PMC9257369
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Micro-flow imaging accurately distinguishes neoplastic from non-neoplastic gallbladder polypoid lesions with high sensitivity and specificity, showing superior consistency with contrast-enhanced ultrasound compared to conventional color Doppler flow imaging.

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This retrospective study evaluated the diagnostic value of micro-flow imaging (MFI) for characterizing blood flow in gallbladder polypoid lesions. Researchers analyzed clinical and ultrasound data from 73 patients, comparing MFI against color Doppler flow imaging and contrast-enhanced ultrasound to differentiate between tumor and non-tumor polyps. The results indicated that MFI demonstrated significantly higher consistency with contrast-enhanced ultrasound than standard Doppler methods, achieving high sensitivity and specificity for distinguishing lesion types. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

ObjectiveTo explore the value of micro-flow imaging (MFI) in evaluating blood flow characteristics and differential diagnosis of gallbladder polypoid lesions.MethodsWe retrospectively analyzed the clinical data and ultrasound images of 73 patients with gallbladder polypoid lesions, including 24 patients with pathologically confirmed neoplastic polyps (n=24) and 49 with non-neoplastic polyps (n=49). All the patients underwent conventional ultrasound, MFI and contrast enhanced ultrasound (CEUS) before cholecystectomy. The blood flow characteristics of the lesions in color Doppler flow imaging (CDFI) and MFI were compared, and the consistency of the findings by these two modalities with those of CEUS were evaluated by weighted Kappa consistency test. The diagnostic performance of MFI for gallbladder polypoid lesions was assessed.ResultsThere were significant differences between MFI and CDFI in the evaluation of blood flow characteristics of gallbladder polypoid lesions (χ2=37.684, P < 0.001). MFI showed better performance than CDFI in displaying the blood flow characteristics of the polyps. The consistency in the findings was 0.118 between CDFI and CEUS and 0.816 between MFI and CEUS. The sensitivity, specificity and accuracy of MFI in distinguishing neoplastic polyps from non-neoplastic polyps were 75.00%, 93.88% and 87.67%, respectively.ConclusionMFI has a good consistency with CEUS in displaying the blood flow characteristics of gallbladder polypoid lesions and can accurately distinguish neoplastic polyps from non-neoplastic polyps, thus providing new ultrasound diagnostic evidence to support clinical decisions on optimal treatments of gallbladder polypoid lesions.
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南方医科大学学报 ›› 2022, Vol. 42 ›› Issue (6): 922-928.doi: 10.12122/j.issn.1673-4254.2022.06.17 朱连华，韩 鹏，姜 波，李 楠，费 翔 - 解放军总医院第一医学中心超声诊断科，北京 100853 ZHU Lianhua, HAN Peng, JIANG Bo, LI Nan, FEI Xiang - Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, Beijing 100853, China 摘要： 目的 探讨微血流成像（MFI）评价胆囊息肉样病变血流灌注特征及鉴别诊断的价值。方法 回顾性分析73例胆囊息肉样病变患者的临床资料和超声图像，根据病理结果分为肿瘤性息肉组（n=24）和非肿瘤性息肉组（n=49）。所有患者在胆囊切除术前均行常规超声、MFI和超声造影（CEUS）检查。比较彩色多普勒血流成像（CDFI）和MFI评价胆囊息肉样病变血流灌注特征的差异。运用加权Kappa一致性检验评估CDFI和MFI观察血流灌注特征与CEUS的一致性，并评价MFI在胆囊息肉样病变中的诊断效能。结果 MFI和CDFI在评价胆囊息肉样病变血流灌注特征方面差异具有统计学意义（χ2=37.684，P<0.001），MFI较CDFI能更准确显示息肉内血流灌注特征。CDFI和MFI对胆囊息肉样病变血流灌注特征评价与CEUS的一致性分别为0.118和0.816。MFI鉴别诊断肿瘤性息肉和非肿瘤性息肉的敏感性、特异性和准确性分别为75.00%、93.88%和87.67%。结论 MFI显示息肉的血流灌注特征与CEUS具有较好的一致性，其能准确鉴别诊断肿瘤性息肉和非肿瘤性息肉，为胆囊息肉样病变患者选择合适的治疗方式提供新的超声诊断依据。

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