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Erschienen in: Abdominal Radiology 10/2017

26.04.2017

Diagnostic nomogram for gallbladder wall thickening mimicking malignancy: using contrast-enhanced ultrasonography or multi-detector computed tomography?

verfasst von: Li-Da Chen, Yang Huang, Xiao-Hua Xie, Wei Chen, Quan-Yuan Shan, Ming Xu, Jin-Ya Liu, Zhi-Qiang Nie, Xiao-Yan Xie, Ming-De Lu, Shun-Li Shen, Wei Wang

Erschienen in: Abdominal Radiology | Ausgabe 10/2017

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Abstract

Objectives

To establish a diagnostic nomogram using contrast-enhanced ultrasonography (CEUS) in gallbladder wall thickening mimicking malignancy and compare with multi-detector computed tomography (MDCT).

Methods

Seventy-two patients with gallbladder wall thickening on B-mode ultrasonography (BUS) were examined by CEUS to develop independent predictors for diagnosing gallbladder carcinoma. Among the 72 cases, 48 patients underwent both CEUS and MDCT. The diagnostic performances of different sets of CEUS criteria and MDCT were compared. A prediction model of malignancy using CEUS was developed. The performance of the nomogram was assessed with respect to its calibration, discrimination, and clinical usefulness.

Results

Multivariate logistic regression indicated that inhomogeneous enhancement in the arterial phase was the strongest independent predictor of malignancy (odds ratio, OR 51.162), followed by interrupted inner layer (OR 19.788), washout time ≤40 s (OR 16.686), and wall thickness >1.6 cm (OR 3.019), which were all selected into the nomogram. Combined with the above significant features, the diagnostic performance of CEUS (AUC = 0.917) was higher than that of MDCT (AUC = 0.788, P = 0.070). The predictive model using CEUS showed good discrimination, with a concordance index of 0.974 (0.950 through internal validation), and good calibration. Decision curve analysis demonstrated that the nomogram was clinically useful.

Conclusions

CEUS could accurately differentiate between malignant and benign gallbladder wall thickening with equivalent efficacy compared to MDCT. The proposed nomogram could be conveniently used to facilitate the preoperative individualized prediction of malignancy in patients with gallbladder wall thickening.
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Metadaten
Titel
Diagnostic nomogram for gallbladder wall thickening mimicking malignancy: using contrast-enhanced ultrasonography or multi-detector computed tomography?
verfasst von
Li-Da Chen
Yang Huang
Xiao-Hua Xie
Wei Chen
Quan-Yuan Shan
Ming Xu
Jin-Ya Liu
Zhi-Qiang Nie
Xiao-Yan Xie
Ming-De Lu
Shun-Li Shen
Wei Wang
Publikationsdatum
26.04.2017
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 10/2017
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-017-1162-z

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