渡辺 文利¹, 花井 洋行¹, 金子 栄蔵¹, 本田 西男¹, 錦野 光浩², 杉山 高³, 秋山 敏一³

Fumitoshi WATANABE¹, Hiroyuki HANAI¹, Eizo KANEKO¹, Nishio HONDA¹, Mitsuhiro NISHIKINO², Kou SUGIYAMA³, Toshikazu AKIYAMA³

¹浜松医科大学第一内科, ²藤枝市立志太総合病院外科, ³藤枝市立志太総合病院起音波検査部

¹First Department of Internal Medicine, Hamamatsu University, ²Department of Surgery, Shida Municipal General Hospital, ³Ultrasound Laboratory Section, Shida Municipal General Hospital

キーワード : Ultrasound, Gallbladder (:polyp)

Polypoid lesions in the gallbladder (PLG), which were less than 2 cm in diameter, were detected in 157 out of 12,720 patients who underwent ultrasonographic examination (US).
Diagnostic criteria of the PLG by US are as follows; (1) the lesions are to be fixed on the gallbladder wall, (2) the lesions do not cast acoustic shadows.
The smallest size of the PLG detected by US was 3 mm in diameter and 95% of all the PLGs were less than 10 mm.
Sixty three percent of them were located on the body of the gallbladder, 27% on the neck and 10% on the funds.
US and PTC were most reliable. If we compared the diagnostic accuracy among US and the other methods of cholecystography like DIC, ERC and PTC.
Eighteen out of 157 patients underwent surgical intervention. Histology of them revealed 9 cholesterol, 3 hyperplastic polyp, 1 cholesterol polyp combined with hyperplastic polyp, 1 inflammatory, 2 cholesterol polyp combined with adenomyomatosis, 1 adenomatous polyp combined with cholesterol polyp and 1 early carcinoma.
The echo levels of the cholesterol polyps are higher than that of the liver parenchyma, which is sonographically indistinguishable from that of polypoid carcinoma.