Abstract
For the differential diagnosis of gallbladder (GB) diseases with thickened wall, 39 cases including 17 chronic cholecystitis, 11 adenomyomatosis and 11 carcinoma were subjected to the study of endoscopic ultrasonography (EUS) prior to surgery and their pathology was studied on the resected specimens. On EUS images chronic cholecystitis showed 3-layered structure or high echoic wall. Adenomyomatosis showed moderately to highly thickened low echoic wall with cystic regions, and carcinoma had highly thickened heterogeneous low echoic wall with irregular surface. From these findings, six features of GB wall including: 1. thickness, 2. presence of 3-layered structure, 3. echo level, 4. internal echo, 5. presence of irregular surface and 6. presence of cystic regions, were chosen as factors for the quantification theory type 2 of the multivariate analysis. Correlation ratios obtained by the method were 0.854 and 0.713 for the axis 1 and 2 respectively. They were well differentiated each other and the total correct diagnosis rate was 92%. Five factors on GB wall except for factor 4 were determined to be important by the evaluation of ranges of standardized category scores obtained by the analysis. In conclusion, the quantification theory type 2 was useful for differentiation of EUS images of GB diseases with thickened wall. Thickness, presence of 3-layered structure, echo level, presence of irregular surface, and presence of cystic regions of the GB wall were important for differential diagnosis of these diseases.
