The Role of EUS in the Differential Diagnosis of Polypoid Lesions of the Gallbladder: Update
EUS는 통상적인 US보다 좋은 영상을 제공하기 때문에 콜레스테롤 용종과 다른 악성 용종과의 감별에 도움을 준다. 그러나 10 mm 이하의 작은 용종성 병변에서는 치료를 결정함에 있어 결정적인 역할을 하는 데는 아직 제한점이 있다. 담낭의 용종성 병변에서 비악성, 악성 그리고 악성화 가능성이 있는 용종성 병변들을 감별하고자 다양한 소견을 통한 점수제 방법과 조영제를 이용한 조영증강 EUS 검사 등의 새로운 검사기법들의 시도가 이루어지고 있어 담낭용종성 병변의 감별과 치료에 도움이 되고 있다.
Although most gallbladder (GB) polyps are benign, some early carcinomas of the GB share the same appearance as benign polyps. Currently, GB polyps larger than 1 cm should be surgically removed because of the increased risk of malignancy. Distinguishing between nonneoplastic, neoplastic, and potentially malignant lesions is a major diagnostic dilemma, and the therapeutic options for these lesions remain controversial. Endoscopic ultrasonography (EUS) is considered to be superior to conventional US for imaging GB lesions, because EUS can provide highresolution images of small lesions with higher ultrasound frequencies. However, differential diagnosis remains difficult, especially for small GB polyps. Thus, various diagnostic methods using EUS have been introduced to overcome difficulty for differential diagnosis between neoplastic and non-neoplastic polyps. Contrastenhanced harmonic EUS is useful for observing microvascular patterns and additional enhancement images of GB polyps. This is needed a post-recording analysis due to a short enhancement time. Real-time color Doppler-EUS provides the Doppler flow of vessels without a time limit.