Abdominal Radiology

, Volume 43, Issue 5, pp 1134–1142 | Cite as

Contrast-enhanced ultrasonography improves the diagnostic specificity for gallbladder-confined focal tumors

  • Bowen Zhuang
  • Wei Li
  • Wei Wang
  • Manxia Lin
  • Ming Xu
  • Xiaoyan Xie
  • Mingde Lu
  • Xiaohua Xie



To investigate the value of contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of malignant and benign focal gallbladder diseases confined to the gallbladder wall.


From July 2006 to May 2016, 88 patients (mean age 48.8 years; age range 18–77 years) were enrolled. All patients had focal gallbladder lesions confined to the gallbladder wall according to CEUS examination. The conventional ultrasound and CEUS characteristics of the lesions were evaluated, and diagnostic performance was evaluated via receiver-operating characteristic (ROC) analysis.


Multiple logistic regression analysis showed that three characteristics, an irregular shape, branched intralesional vessels and hypo-enhancement in the late phase, were features indicating a malignant gallbladder disease (all P < 0.05). When combining any two of these three features, diagnostic specificity improved from 51.5%–77.3% to 92.4% (P < 0.05 for all), and the area under the ROC (AUROC) curve improved from 0.735–0.874 to 0.917, without a significant loss of sensitivity.


CEUS features have greater specificity than those from conventional US for the differentiation of benign and malignant gallbladder diseases confined to the gallbladder wall, without a loss of sensitivity.


Gallbladder disease Differential diagnosis Neoplasm Contrast-enhanced ultrasonography 


Compliance with ethical standards


Science and Technology Planning Project of Guangdong Province, China (2012B031800459). National Natural Science Foundation of China (81601500). Natural Science Foundation of Guangdong Province, China (2016A030310143).

Conflict of interest

All the authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed consent

A waiver of informed consent was obtained from the institutional review board as this was a retrospective study and all patients underwent CEUS as part of their clinical work-up.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Bowen Zhuang
    • 1
  • Wei Li
    • 1
  • Wei Wang
    • 1
  • Manxia Lin
    • 1
  • Ming Xu
    • 1
  • Xiaoyan Xie
    • 1
  • Mingde Lu
    • 1
    • 2
  • Xiaohua Xie
    • 1
  1. 1.Department of Medical Ultrasonics, Institute of Diagnostic and Interventional UltrasoundThe First Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouPeople’s Republic of China
  2. 2.Department of Hepatobiliary SurgeryThe Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouChina

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