Related Experiment Video

Updated: May 16, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
07:44

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction

Published on: March 25, 2022

Differential diagnosis between gallbladder adenomas and cholesterol polyps on contrast-enhanced harmonic endoscopic

Chan Hyuk Park1, Moon Jae Chung, Tak Geun Oh

  • 1Division of Gastroenterology, Yonsei Institute of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea.

Surgical Endoscopy
|December 13, 2012
PubMed

Insights

Contrast-enhanced harmonic EUS (CEH-EUS) shows potential for differentiating gallbladder adenomas from cholesterol polyps. Visual assessment of enhancement patterns offers a useful, though not definitive, diagnostic approach.

Area of Science:

  • Gastroenterology
  • Diagnostic Imaging
  • Endoscopic Ultrasonography

Background:

  • Differentiating gallbladder (GB) adenomas and cholesterol polyps is difficult using conventional ultrasonography or endoscopic ultrasonography (EUS) due to similar echogenicity and morphology.
  • Contrast-enhanced harmonic EUS (CEH-EUS) offers a potential solution for improved diagnostic accuracy.

Purpose of the Study:

  • To evaluate the effectiveness of CEH-EUS in distinguishing between GB adenomas and cholesterol polyps.
  • To assess the diagnostic performance of CEH-EUS based on enhancement patterns.

Main Methods:

  • Retrospective review of 87 patients with GB polyps who underwent CEH-EUS between June 2010 and December 2011.
  • Analysis of CEH-EUS enhancement patterns (homogeneous vs. heterogeneous) in relation to pathological findings.

Main Results:

  • Of 57 patients who underwent cholecystectomy, 34 had confirmed pathologies including adenoma and cholesterol polyp.
  • CEH-EUS showed homogeneous enhancement in 6 adenomas and 4 cholesterol polyps, and heterogeneous enhancement in 2 adenomas and 8 cholesterol polyps.
  • Sensitivity and specificity of CEH-EUS for differentiating GB adenomas from cholesterol polyps were 75.0% and 66.6%, respectively.

Conclusions:

  • CEH-EUS, based on enhancement patterns, may aid in distinguishing GB adenomas from cholesterol polyps.
  • Subjectivity in visual assessment necessitates further investigation with techniques like quantitative perfusion analysis for definitive diagnosis.
Abstract

Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Cholecystitis01:20

Cholecystitis

Cholecystitis is inflammation of the gallbladder, most commonly caused by obstruction of the cystic duct. This blockage prevents bile from draining, leading to gallbladder distension, inflammation, and potentially serious complications. This condition may present acutely or chronically and can happen with or without gallstones.EtiologyAbout 95% of cholecystitis cases are calculous, caused by gallstones blocking the cystic duct, leading to bile accumulation and inflammation of the gallbladder...
Ultrasound II: Endoscopic Ultrasound and FibroScan01:25

Ultrasound II: Endoscopic Ultrasound and FibroScan

Endoscopic Ultrasound (EUS) and FibroScan are valuable diagnostic tools in gastroenterology and hepatology, each with specific applications and techniques.
Endoscopic Ultrasound (EUS):
Gallbladder01:17

Gallbladder

The gallbladder is a small, pear-shaped organ that plays a crucial role in our digestive system. Measuring about 10 cm in length, it is comparable in size to a kiwi fruit and is located in a hollow area on the lower surface of the liver. The gallbladder's primary function is to store and concentrate bile, a fluid produced by the liver that aids in digestion.
The gallbladder's anatomy consists of three regions: the fundus, body, and neck. Extending from the neck, the cystic duct joins the common...
Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies01:28

Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies

Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Diseases of the Liver and Gallbladder01:26

Diseases of the Liver and Gallbladder

Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not related to...