ABSTRACT

Background

The accurate characterization of gallbladder wall thickening (GWT) into benign or malignant on ultrasound (US) is a significant challenge.

Methods

We searched the MEDLINE and EMBASE databases for studies reporting two-dimensional grayscale US in benign and malignant GWT. The pooled prevalence was calculated using a generalized linear mixed method with a random-effects model. The pooled sensitivity and specificity were calculated using a bivariate random-effects model.

Results

Of the 7309 studies screened by titles, 73 studies with 18,008 patients were included. The most common findings in xanthogranulomatous cholecystitis (XGC) were lack of wall disruption and intramural hypoechoic nodules while adenomyomatosis (ADM) was frequently associated with intramural cysts and intramural echogenic foci. Echogenic foci, lack of gallbladder wall disruption, and hypoechoic nodules had a sensitivity of 89%, 77%, and 66% and specificity of 86%, 51%, and 80%, respectively for the diagnosis of benign GWT. Focal thickening and indistinct liver interface had a sensitivity of 75% and 55% and specificity of 64% and 69%, respectively for the diagnosis of malignant GWT.

Conclusion

intramural features (echogenic foci, hypoechoic nodules), gallbladder wall disruption, and liver interface are useful US features for the characterization of GWT.

中文翻译：

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用于表征非急性环境中胆囊壁增厚的灰度超声检查结果：系统评价和荟萃分析

摘要

背景

在超声 (US) 上准确地将胆囊壁增厚 (GWT) 表征为良性或恶性是一项重大挑战。

方法

我们在 MEDLINE 和 EMBASE 数据库中搜索了报告二维灰度 US 在良性和恶性 GWT 中的研究。使用具有随机效应模型的广义线性混合方法计算汇总患病率。使用双变量随机效应模型计算汇总的敏感性和特异性。

结果

在按标题筛选的 7309 项研究中，纳入了 73 项研究，涉及 18,008 名患者。黄色肉芽肿性胆囊炎 (XGC) 最常见的发现是缺乏壁破裂和壁内低回声结节，而腺肌瘤病 (ADM) 经常与壁内囊肿和壁内回声灶相关。回声灶、无胆囊壁破裂和低回声结节对诊断良性 GWT 的敏感性分别为 89%、77% 和 66%，特异性分别为 86%、51% 和 80%。局灶性增厚和肝界面模糊对恶性 GWT 诊断的敏感性分别为 75% 和 55%，特异性分别为 64% 和 69%。

结论

壁内特征（回声灶、低回声结节）、胆囊壁破裂和肝界面是表征 GWT 的有用的 US 特征。