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Hypoechoic foci on EUS are simple and strong predictive factors for neoplastic gallbladder polyps

 Jae Hee Cho  ;  Jeong Youp Park  ;  Yoon Jae Kim  ;  Hee Man Kim  ;  Hong Jeong Kim  ;  Sung Pil Hong  ;  Seung Woo Park  ;  Jae Bock Chung  ;  Si Young Song  ;  Seungmin Bang 
 GASTROINTESTINAL ENDOSCOPY, Vol.69(7) : 1244-1250, 2009 
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Adult ; Aged ; Cholecystectomy ; Endosonography ; Female ; Gallbladder Neoplasms/diagnostic imaging* ; Gallbladder Neoplasms/pathology ; Gallbladder Neoplasms/surgery ; Humans ; Male ; Middle Aged ; Polyps/diagnostic imaging* ; Polyps/pathology ; Polyps/surgery ; Predictive Value of Tests ; Retrospective Studies
BACKGROUND: EUS is an accurate imaging modality for delineating gallbladder (GB) structures; however, its clinical use in differentiating neoplastic GB polyps from nonneoplastic polyps is limited. Thus, we sought to characterize neoplastic GB polyps by analyzing unique EUS features. Our analysis revealed variably shaped, relatively hypoechoic portions in the core of polyps compared with general background echogenicity. OBJECTIVE: Our purpose was to make a differential diagnosis between neoplastic and nonneoplastic GB polyps of less than 20 mm by use of EUS variables, including hypoechoic foci. DESIGN: Retrospective single-center study. SETTING: University teaching hospital. PATIENTS: Patients (n = 88) underwent preoperative EUS and cholecystectomy for GB polyps smaller than 20 mm. RESULTS: Hypoechoic foci were found in 30 of 33 patients (91%) with neoplastic polyps and 6 of 55 (11%) with nonneoplastic polyps. In a multivariate analysis, hypoechoic foci were the only significant predictive factor for neoplastic polyps (odds ratio [OR] 55.4, 95% CI, 8.26-371, P < .001); the sensitivity and specificity were 90% and 89%, respectively. In addition, polyps >15 mm had an increased risk of malignancy (OR 21.7, 95% CI, 2.35-201, P = .007), as did those with hypoechoic foci (OR 10.9; 95% CI, 1.01-117, P = .049). LIMITATIONS: Retrospective review of selected patients from a tertiary medical center. CONCLUSIONS: The presence of hypoechoic foci on EUS is a strong predictive factor for neoplastic polyps. EUS may be useful in developing a treatment strategy for GB polyps.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yoon Jae(김윤재)
Kim, Hong Jeoung(김홍정)
Kim, Hee Man(김희만)
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Park, Jeong Youp(박정엽) ORCID logo https://orcid.org/0000-0003-0110-8606
Bang, Seungmin(방승민) ORCID logo https://orcid.org/0000-0001-5209-8351
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Chung, Jae Bock(정재복)
Cho, Jae Hee(조재희) ORCID logo https://orcid.org/0000-0003-4174-0091
Hong, Sung Pil(홍성필)
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