Radiology, Vol 196, 493-497, Copyright © 1995 by Radiological Society of North America
Large cholesterol polyps of the gallbladder: diagnosis by means of US and endoscopic US
M Sugiyama, Y Atomi, A Kuroda, T Muto and N Wada
First Department of Surgery, Tokyo University School of Medicine, Japan.
PURPOSE: To identify ultrasonographic (US) features of large cholesterol
polyps (> 10 mm in diameter) of the gallbladder in the differential
diagnosis of polypoid lesions. MATERIALS AND METHODS: Sixty-seven patients
underwent US (n = 67) and endoscopic US (n = 33). Fourteen patients had
large cholesterol polyps. Findings in these patients were compared with
those in patients with small cholesterol polyps (< or = 10 mm in
diameter; n = 34) or other polypoid lesions (n = 19). RESULTS: US
demonstrated the large cholesterol polyps as pedunculated masses with
granular surfaces. In 94% of patients, all small cholesterol polyps were
echogenic whereas the large cholesterol polyps tended to have decreased
echogenicity. Endoscopic US showed complete or partial aggregation of
echogenic spots in all cholesterol polyps-but not in other polypoid
lesions, which included carcinomas. CONCLUSION: Aggregation of echogenic
spots seems to be a US feature characteristic of both large and small
cholesterol polyps. Routine use of endoscopic US is recommended for
differential diagnosis of polypoid lesions because of its high resolution.
