1First Department of Internal Medicine, Hamamatsu University, 2Department of Surgery, Shida Municipal General Hospital, 3Ultrasound Laboratory Section, Shida Municipal General Hospital
Ultrasound, Gallbladder (:polyp)
Polypoid lesions in the gallbladder (PLG), which were less than 2 cm in diameter, were detected in 157 out of 12,720 patients who underwent ultrasonographic examination (US). Diagnostic criteria of the PLG by US are as follows; (1) the lesions are to be fixed on the gallbladder wall, (2) the lesions do not cast acoustic shadows. The smallest size of the PLG detected by US was 3 mm in diameter and 95% of all the PLGs were less than 10 mm. Sixty three percent of them were located on the body of the gallbladder, 27% on the neck and 10% on the funds. US and PTC were most reliable. If we compared the diagnostic accuracy among US and the other methods of cholecystography like DIC, ERC and PTC. Eighteen out of 157 patients underwent surgical intervention. Histology of them revealed 9 cholesterol, 3 hyperplastic polyp, 1 cholesterol polyp combined with hyperplastic polyp, 1 inflammatory, 2 cholesterol polyp combined with adenomyomatosis, 1 adenomatous polyp combined with cholesterol polyp and 1 early carcinoma. The echo levels of the cholesterol polyps are higher than that of the liver parenchyma, which is sonographically indistinguishable from that of polypoid carcinoma.