CONTRAST-ENHANCED EUS FOR GALLBLADDER DISEASES

Abstract

Compared to CT and MRI, EUS has superior spatial and temporal resolutions and is useful for diagnosis of gallbladder diseases. Although we generally differentiate between benign and malignant gallbladder diseases based on the size and morphology, morphological diagnosis has its limitations. Contrast-enhanced EUS has enabled real-time hemodynamic evaluation under EUS observation. Particularly, with the advent of contrast-enhanced harmonic EUS using the second-generation ultrasound contrast agents, contrast effects can be observed in greater detail for a longer time. This review describes the usefulness of contrast-enhanced EUS in gallbladder diseases based on previous literature. In gallbladder diseases, contrast-enhanced EUS plays a role not only in differentiation between biliary sludge and neoplastic lesions, but also in qualitative diagnosis between benign and malignant, in staging, and assistance in EUS-FNA. However, there have been no large-scale studies of contrast-enhanced EUS in gallbladder diseases, and further research with a high level of evidence is awaited.