The use of Ultrasound has improved the detection of gallbladder polyps, yet it is associated with some limitations in evaluating the nature of gallbladder polyps, especially the maximum size of 1.0 to 1.5 cm. 

A recent study assessed the value of the ultrasound scoring system founded on independent predictive parameters in differentiating adenomatous polyps from cholesterol polyps with a maximum size of 1.0 to 1.5 cm.

It enrolled 163 patients with gallbladder polyps (1.0 to 1.5 cm) who underwent ultrasonography and cholecystectomy; and compared Ultrasound image characteristics between cholesterol polyps and adenomatous polyps. The study constracted an ultrasound scoring system in the training cohort and evaluated its diagnostic performance in the validation cohort.

The study found-

• A significant difference in maximum size, height/width ratio, stone or sludge, vascularity, and the hyperechoic spot between cholesterol polyps and adenomatous polyps in the training cohort.
• lower height/width ratio, presence of vascularity, and absence of hyperechoic spot were the independent predictive parameters for adenomatous polyps.
• The total score were: (height/width ratio, <0.9=4, ≥0.9=0) + (vascularity, present=3, absent=0) + (hyperechoic spot, absent=2, present=0).
• The Sensitivity, specificity, and accuracy of the ultrasound scoring system ≥5 for diagnosis of adenomatous polyps in the validation cohort were 73.33%, 80.49%, and 78.57%, respectively.

This study describes that the ultrasound scoring system helps distinguish adenomatous polyps from cholesterol polyps. Further, it can effectively decrease unnecessary cholecystectomy.

Lianhua Zhu, Peng Han, Bo Jiang, et al. Value of Conventional Ultrasound- based Scoring System in Distinguishing Adenomatous Polyps From Cholesterol Polyps. J Clin Gastroenterol. 2022 Nov-Dec;56(10):895-901. Doi: 10.1097/MCG.0000000000001639.