High Resolution Ultrasonographic Evaluation of the Gallbladder: Value of Advanced Imaging Techniques

Lee, Jae Young; Choi, Byung Ihn; Han, Joon Koo; Lee, Jeong Min; Kim, Se Hyung; Choi, Jin Young; Kim, Su Jin

Abstract

PURPOSE
A prospective study to determine the role of compound imaging, speckle reduction imaging and tissue harmonic imaging techniques in high-resolution gallbladder ultrasound examination. MATERIALS AND METHODS: Gallbladders in 39 patients were examined with conventional imaging, compound imaging, compound imaging combined with speckle reduction imaging, and compound imaging combined with harmonic imaging techniques, using 7- to 10-MHz linear array transducer. The overall image qualities, sharpness of the anterior wall, depiction of the wall layers, and degree of internal artifact were evaluated. In cases of a gallbladder lesion, its conspicuity, margin sharpness, and intensity of posterior shadowing were evaluated. Two radiologists independently evaluated each image and graded each finding with a four-part scale. The Wilcoxon signs rank test was used. RESULTS: Compound imaging technique provided better results than conventional imaging technique in all categories except the intensity of posterior shadowing of gallstone (p < 0.01). Compound imaging technique well depicted the gallbladder wall layers in 34 of 39 cases and depicted them better than conventional ultrasonography in 31 of 39 cases. Compound imaging also improved conspicuity and margin sharpness of the lesions. Combined use of compound imaging and speckle reduction imaging technique did not provide better results than compound imaging. Combined use of compound imaging and harmonic imaging provided better overall image quality and fewer internal artifacts than compound imaging (p < 0.05). CONCLUSION: Compound imaging technique was superior to conventional imaging in evaluating gallbladder and its lesion with high frequency transducer. Combined use of compound imaging and harmonic imaging was helpful to enhance overall image quality and reduce artifacts.