Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Differentiating between Adenomyomatosis and Gallbladder Cancer: Revisiting a Comparative Study of High-Resolution Ultrasound, Multidetector CT, and MR Imaging

  • Bang, Sang Heum (Department of Radiology and the Institute of Radiation Medicine, Seoul National University Hospital) ;
  • Lee, Jae Young (Department of Radiology and the Institute of Radiation Medicine, Seoul National University Hospital) ;
  • Woo, Hyunsik (Department of Radiology and the Institute of Radiation Medicine, Seoul National University Hospital) ;
  • Joo, Ijin (Department of Radiology and the Institute of Radiation Medicine, Seoul National University Hospital) ;
  • Lee, Eun Sun (Department of Radiology and the Institute of Radiation Medicine, Seoul National University Hospital) ;
  • Han, Joon Koo (Department of Radiology and the Institute of Radiation Medicine, Seoul National University Hospital) ;
  • Choi, Byung Ihn (Department of Radiology and the Institute of Radiation Medicine, Seoul National University Hospital)
  • Received : 2013.02.06
  • Accepted : 2013.12.19
  • Published : 2014.04.01
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Abstract

Objective: To compare the diagnostic performance of high-resolution ultrasound (HRUS) with contrast-enhanced CT and contrast-enhanced magnetic resonance imaging (MRI) with MR cholangiopancreatography (MRCP) to differentiate between adenomyomatosis (ADM) and gallbladder cancer (GBCA). Materials and Methods: Forty patients with surgically proven ADM (n = 13) or GBCA at stage T2 or lower (n = 27) who previously underwent preoperative HRUS, contrast-enhanced CT, and contrast-enhanced MRI with MRCP were retrospectively included in this study. According to the well-known diagnostic criteria, two reviewers independently analyzed the images from each modality separately with a five-point confidence scale. The interobserver agreement was calculated using weighted ${\kappa}$ statistics. A receiver operating characteristic curve analysis was performed and the sensitivity, specificity, and accuracy were calculated for each modality when scores of 1 or 2 indicated ADM. Results: The interobserver agreement between the two reviewers was good to excellent. The mean Az values for HRUS, multidetector CT (MDCT), and MRI were 0.959, 0.898, and 0.935, respectively, without any statistically significant differences between any of the modalities (p > 0.05). The mean sensitivity of MRI with MRCP (80.8%) was significantly higher than that of MDCT (50.0%) (p = 0.0215). However, the mean sensitivity of MRI with MRCP (80.8%) was not significantly different from that of HRUS (73.1%) (p > 0.05). The mean specificities and accuracies among the three modalities were not significantly different (p > 0.05). Conclusion: High-resolution ultrasound and MRI with MRCP have comparable sensitivity and accuracy and MDCT has the lowest sensitivity and accuracy for the differentiation of ADM and GBCA.

Keywords

Acknowledgement

Grant : Ultrasound Multi-harmonic Imaging Techniques

Supported by : MKE/KEIT

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