What is it about?

Contrast-enhanced ultrasound (CE-US) diagnosis of invasion depth of gallbladder carcinoma (GBC) is described. While a polypoid gallbladder neoplasm with a deep hypoechoic area on ultrasound (US) suggests T2 GBC, it is challenging to detect a tiny hypoechoic area. In contrast, CEUS is effective in the differential diagnosis between malignant and benign gallbladder neoplasms in the vascular phase, and additionally, it can highlight a tiny desmoplastic area in T2 GBC as a more clearly unenhanced area in the perfusion phase than a deep hypoechoic area.

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Why is it important?

A deep unenhanced area in the perfusion phase on CE-US is on par with a deep hypoechoic area on ultrasound (US), also corresponding to non-cancerous fibrosis. Furthermore, it more clearly suggests the advancing border of T2 GBC with abundant fibrosis and lymphocytic infiltration compared to a deep hypoechoic area. Radical resection provides a favorable prognosis for patients with shallow T2 GBC.

Perspectives

Diagnosing shallow T2 GBC using CE-US is crucial. CE-US may offer substantial information for surgical planning. However, both non-cancerous fibrosis and desmoplastic area in T2 GBC are delineated similarly on CE-US.

Ph.D., M.D. Taketoshi Fujimoto
Iida Hospital

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This page is a summary of: A deep unenhanced area on contrast‐enhanced ultrasound suggests T2 gallbladder carcinoma, Journal of Clinical Ultrasound, August 2024, Wiley,
DOI: 10.1002/jcu.23789.
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