Ultrasonographic angiography in gallbladder diseases

Ultrasonographic (US) angiography was performed by sonographic examination with injection of carbon dioxide microbubbles through a catheter following conventional angiography in 41 patients with various gallbladder diseases. Three enhancement patterns were found; strong enhancement in the lesion from the periphery to the center was noted in patients with adenocarcinoma and benign polyp (type I), irregular partial enhancement at the margins of the lesion in those with adenosquamous carcinoma (type II), and internal regular enhancement in those with chronic cholecystitis, xanthogranulomatous cholecystitis and adenomyomatosis (type III). Pseudopolypoid lesion such as gallbladder debris showed no enhancement. US angiography may be useful in the differential diagnosis of gallbladder diseases, especially to differentiate the wall thickening type of gallbladder carcinoma from chronic cholecystitis or adenomyomatosis, and the pseudopolypoid lesion and fundal type of adenomyomatosis from benign polyp or polypoid-type carcinoma.