Analysis of the causes of misdiagnosis of gallbladder adenomyoma by ultrasound / 中华超声影像学杂志

ABSTRACT

Objective:To analyze the factors of missed diagnosis and misdiagnosis of gallbladder adenomyomatosis(GBA) by ultrasonography according to the contrast between ultrasonography and pathology.Methods:Four hundred and forty-six cases of patients with pathological diagnosis of GBA and complete preoperative case informations were retrospectively collected from January 2010 to November 2018 in the PLA General Hospital, and the preoperative ultrasound diagnosis, clinical symptoms, pathological classification were analyzed. The coincidence rate and missed diagnosis rate of GBA by ultrasound were calculated. The ultrasonic diagnosis of GBA missed diagnosis and misdiagnosis factors were analyzed according to the multiple factors and single factor Logistic regression.Results:The coincidence rate of ultrasonic diagnosis was 46.9%(200/426), the missed diagnosis rate was 35.2%(150/426), and the misdiagnosis rate was 17.8%(76/426). Misdiagnosed cases included 65 cases (85.5%) of gallbladder occupation, 7 cases (9.2%) of gallbladder stones, and 4 cases (5.3%) of chronic cholecystitis. The results of multi-fact OR Logistics regression analysis showed that gallbladder stones ( OR=5.112, P<0.001), chronic cholecystitis ( OR=4.613, P<0.001), gallbladder occupation ( OR=6.565, P<0.001) and cholesterol crystals ( OR=8.634, P<0.001) were independent influencing factors for accurate diagnosis of GBA by ultrasound. Conclusions:Ultrasound has a high rate of missed diagnosis and misdiagnosis for GBA operation group at present. Since most cases are complicated with other gallbladder diseases, it is important to scan carefully for GBA besides the diagnosis of a single gallbladder disease.