西村 庸夫¹, 若林 久男¹, 大久保 博忠¹, 赤松 興一¹, 太田 康幸¹, 大越 輝紀², 藤石 秀三²

Nobuo NISHIMURA¹, Hisao WAKABAYASHI¹, Hirotada OHKUBO¹, Kouichi AKAMATSU¹, Yasuyuki OHTA¹, Terunori OHKOSHI², Shuuzou FUJIISHI²

¹愛媛大学医学部第3内科, ²町立吉田総合病院外科

¹Third Department of Internal Medicine, Ehime University School of Medicine, ²Department of Surgery, Yoshida General Hospital

キーワード : Ultrasound, Carcinoma, Cholesterol polyp, Rokitansky-Aschoff sinus, Adenomyomatosis

It is quite difficult to distinguish carcinoma from other types of benign polypoid lesions of the gallbladder with ultrasound. We experienced 14 patients with polypoid lesions of the gallbladder in whom ultrasound examination and cholecystectomy were performed and echo levels of the polypoids and histological types were compared.
The echogenicity of cholesterol polyps and adenomyomatosis in abundance with Rokitansky-Aschoff sinuses were higher than that of the liver parenchyma at the same depth. However, adenomyomatosis with a few Rokitansky-Aschoff sinuses had almost the same echo level with the liver parenchyma. Adenomas of the gallbladder had the higher echo level than carcinomas.
Hystological findings suggest that the echogenicity of polypoid lesions of the gallbladder depend on the volume density of the ductal structures, the cystic formations and / or the foam cells.