Prevalence And Risk Factors Of Gallbladder Polypoid Lesions And A Comparison Between Contrast-enhanced Ultrasonography And CT In Ability Of Differential Diagnosis

ObjectiveTo investigate the prevalence and risk factors of polypoid lesions of gallbladder (PLG) of urban population in Shanghai, China and to evaluate the ability of differential diagnostic between contrast-enhanced ultrasonography (CEUS) and CT for gallbladder neoplastic and non-neoplastic polyps. Background:Gallbladder polypoid lesion (PLG) is a common disease. Its prevalence is differ from region and race and its risk factors are still under dispute. PLG contains two type:neoplastic polyps and non-neoplastic polyps. They have different treatment strategies and outcomes while the differential diagnosis is challenging. However, recent technical advancements may bring a solution.MethodsA total of 83423 subjects who underwent health examinations in our hospital between January 2014 and December 2014 were analyzed retrospectively. The participants received a series of physical examination items, including interview, physical measurements, laboratory assessments and ultrasound examination.Patients diagnosed as gallbladder polypoid lesion with the lesion larger than 10mm in our department between October 2013 and December 2014 were analyzed prospectively. The subjects received both CEUS and CT screening examinations and followed by a surgical resection. Clinical image diagnoses were compared with histopathologic results in terms of pathologic prediction.ResultsPLG were identified 5.22% of all subjects, including 3.61% of women and 6.35% of men. Multiple logistic regression demonstrate an influence on the occurrence of PLG for the risk as follow (in a descending order):atherosclerotic plaque, fatty live, middle age, body-mass index (BMI), male gender, serum cholesterol (T-Cho) and low-density lipoprotein (LDL) level. The sensitivity of CEUS for neoplastic lesions was 73.3%, the specificity was 83.3%; and the sensitivity of CT was 93.3%, the specificity was 75.0%.ConclusionThe prevalence of PLG reported in our study (5.22%) is similar as figures published previously. Majority of the polyp were solitary. Male gender, middle age, overweight, atherosclerotic plaque, fat live, T-Cho and LDL level could be regarded as risk factors in the target population in Shanghai, China. Both CEUS and CT were useful for distinguishing neoplastic and non-neoplastic polyps. For lesions of more than 10mm in diameter, the ability of differential diagnostic of CT was better than CEUS.