Endoscopic sonography in the diagnosis of gallbladder wall lesions in patients with gallstones

✍ Scribed by Naoki Muguruma; Seisuke Okamura; Soichi Ichikawa; Koji Tsujigami; Masaharu Suzuki; Masaya Tadatsu; Yoshihiro Kusaka; Yoshio Okita; Mitsuyasu Yano; Susumu Ito

• Publisher: John Wiley and Sons
• Year: 2001
• Tongue: English
• Weight: 245 KB
• Volume: 29
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.1055

✦ Synopsis

Abstract

Purpose

The purpose of this study was to evaluate the diagnostic accuracy of endoscopic sonography (EUS) in the detection of gallbladder wall lesions in patients with and without gallstones.

Methods

We retrospectively reviewed the medical records, sonograms, and sonographic reports of 62 patients who underwent cholecystectomy for gallbladder wall lesions evaluated by EUS. We assessed the accuracy of EUS in diagnosing gallbladder wall lesions in the presence or absence of gallstones and on the basis of the size and number of stones and the size of the gallbladder wall lesions. We also evaluated the effect of acoustic shadowing. The EUS results were compared with the histopathologic results.

Results

EUS correctly diagnosed the gallbladder wall lesions in 17 (71%) of 24 patients with gallstones and in 34 (89%) of 38 patients without gallstones. The diagnostic accuracy of EUS was 86% in patients with gallbladder wall lesions smaller than 20 mm and 79% in patients with gallbladder wall lesions 20 mm or larger. The diagnostic accuracy was 75% in patients with gallstones smaller than 5 mm and 67% in patients with stones 5 mm or larger. The accuracy was 67% in patients with 1–5 stones and 83% in patients with 6 or more stones. None of these differences was statistically significant. Acoustic shadowing did not affect the diagnostic accuracy of EUS.

Conclusions

The diagnostic accuracy of EUS for gallbladder wall lesions is not affected by the presence of gallstones. However, better diagnostic criteria must be established based on larger studies, and technical refinements of the equipment are needed to increase the accuracy of EUS in the diagnosis of gallbladder wall lesions. © 2001 John Wiley & Sons, Inc. J Clin Ultrasound 29:395–400, 2001.