Contrast-enhanced ultrasound for differentiation of gallbladder sludge from polyp: A case report demonstrating clinical utility

Gallbladder lesion characterization remains a common diagnostic dilemma in abdominal imaging, particularly when differentiating between polyps and organized sludge. Findings on conventional gray-scale ultrasound may be equivocal, especially when typical imaging features such as mobility are absent....

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Main Authors: Zeyad F. Elias, BSc, Stefanie Y. Lee, MD, FRCPC
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325002225
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author Zeyad F. Elias, BSc
Stefanie Y. Lee, MD, FRCPC
author_facet Zeyad F. Elias, BSc
Stefanie Y. Lee, MD, FRCPC
author_sort Zeyad F. Elias, BSc
collection DOAJ
description Gallbladder lesion characterization remains a common diagnostic dilemma in abdominal imaging, particularly when differentiating between polyps and organized sludge. Findings on conventional gray-scale ultrasound may be equivocal, especially when typical imaging features such as mobility are absent. We present a case of a 65-year-old patient who presented with a concerning nonmobile 3.7 cm gallbladder lesion on initial ultrasound assessment. Due to the superior sensitivity of contrast-enhanced ultrasound (CEUS) for blood flow compared to other imaging modalities, CEUS was able to demonstrate complete absence of enhancement within the lesion, consistent with tumefactive sludge rather than solid tissue, and averting the need for additional cross-sectional imaging. Surgical pathology following cholecystectomy confirmed these findings. This case highlights the utility of CEUS as a valuable tool in gallbladder imaging, potentially reducing healthcare costs and expediting appropriate patient care while avoiding the risks associated with other contrast-enhanced imaging modalities.
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spelling doaj-art-e9f85dfec9e241e1ae2244a6fd6dd3a62025-08-20T03:09:07ZengElsevierRadiology Case Reports1930-04332025-06-012062980298310.1016/j.radcr.2025.03.012Contrast-enhanced ultrasound for differentiation of gallbladder sludge from polyp: A case report demonstrating clinical utilityZeyad F. Elias, BSc0Stefanie Y. Lee, MD, FRCPC1Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, CanadaDepartment of Medical Imaging, McMaster University; Hamilton Health Sciences, Juravinski Hospital and Cancer Centre, Hamilton, Ontario, Canada; Corresponding author.Gallbladder lesion characterization remains a common diagnostic dilemma in abdominal imaging, particularly when differentiating between polyps and organized sludge. Findings on conventional gray-scale ultrasound may be equivocal, especially when typical imaging features such as mobility are absent. We present a case of a 65-year-old patient who presented with a concerning nonmobile 3.7 cm gallbladder lesion on initial ultrasound assessment. Due to the superior sensitivity of contrast-enhanced ultrasound (CEUS) for blood flow compared to other imaging modalities, CEUS was able to demonstrate complete absence of enhancement within the lesion, consistent with tumefactive sludge rather than solid tissue, and averting the need for additional cross-sectional imaging. Surgical pathology following cholecystectomy confirmed these findings. This case highlights the utility of CEUS as a valuable tool in gallbladder imaging, potentially reducing healthcare costs and expediting appropriate patient care while avoiding the risks associated with other contrast-enhanced imaging modalities.http://www.sciencedirect.com/science/article/pii/S1930043325002225GallbladderContrast-enhanced ultrasound (CEUS)Cost-effectivenessUltrasoundGallbladder polypGallbladder sludge
spellingShingle Zeyad F. Elias, BSc
Stefanie Y. Lee, MD, FRCPC
Contrast-enhanced ultrasound for differentiation of gallbladder sludge from polyp: A case report demonstrating clinical utility
Radiology Case Reports
Gallbladder
Contrast-enhanced ultrasound (CEUS)
Cost-effectiveness
Ultrasound
Gallbladder polyp
Gallbladder sludge
title Contrast-enhanced ultrasound for differentiation of gallbladder sludge from polyp: A case report demonstrating clinical utility
title_full Contrast-enhanced ultrasound for differentiation of gallbladder sludge from polyp: A case report demonstrating clinical utility
title_fullStr Contrast-enhanced ultrasound for differentiation of gallbladder sludge from polyp: A case report demonstrating clinical utility
title_full_unstemmed Contrast-enhanced ultrasound for differentiation of gallbladder sludge from polyp: A case report demonstrating clinical utility
title_short Contrast-enhanced ultrasound for differentiation of gallbladder sludge from polyp: A case report demonstrating clinical utility
title_sort contrast enhanced ultrasound for differentiation of gallbladder sludge from polyp a case report demonstrating clinical utility
topic Gallbladder
Contrast-enhanced ultrasound (CEUS)
Cost-effectiveness
Ultrasound
Gallbladder polyp
Gallbladder sludge
url http://www.sciencedirect.com/science/article/pii/S1930043325002225
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