What tests should be done for gallbladder polyps?

  1.B ultrasound examination is flexible, accurate, non-invasive, repeatable, inexpensive, and easily accepted by many patients, and can accurately show the size, location, number, and cyst wall of polyps. ultrasound typically shows strong or slightly strong echogenic clusters in the wall of gallbladder in the form of points, small pieces, or sheets, followed by no acoustic shadow, and can see bulbous, mulberry, papillary, and nodular prominence, and even the tip of polyps. Yang Hanliang et al. reported that the detection rate of PLG by ultrasound was 92.7%, the specificity was 94.8%, and the false positive was 5.2%, the accuracy was significantly higher than that of CT. It is believed that BUS can clearly show the location, size, number and local changes of gallbladder wall of PLG, which is a simple and reliable diagnostic method.  2.Three-dimensional ultrasound imaging can make the gallbladder have a three-dimensional sense of spatial orientation, good sound transmission, and the effect of direct view of the gallbladder profile, which can make up for some shortcomings of two-dimensional imaging. It can not only observe the size and shape of gallbladder polyps, but also distinguish the relationship between polyps and gallbladder wall, especially the polyps in the posterior wall of gallbladder. 2D imaging often cannot clearly distinguish whether there is a tip and the scope and depth of the tip attached to the gallbladder wall. Three-dimensional reconstruction can observe the continuity of the lesion and the surface of the lesion through the rotation of different sections, which can help improve the differentiation of gallbladder polyps from adenomas or carcinomas of the gallbladder. Wang Liansheng et al. reported 18 cases of intracholedochal lesions with a maximum diameter of 5.5 cm and a minimum diameter of 0.3 cm using 3D ultrasound imaging, among which 5 cases were multiple polyps, 9 cases were solitary polyps, and 4 cases of gallbladder cancer were multiple occupying lesions. The three-dimensional ultrasound imaging was basically the same as that seen intraoperatively.  3.Endoscopic ultrasound, i.e. transendoscopic ultrasound scanning, is a tiny ultrasound probe placed at the tip of the endoscope with a high-frequency probe, and the endoscope is inserted into the digestive tract.  4, CT simulation endoscopy technology since 1994 Vining and other first reported, a number of foreign scholars of this technology for experimental and clinical applications of research, CTVE imaging principle is the use of computer software functions, the spiral CT volume scan image data obtained by post-processing, reconstruction of the cavity organ internal surface of the three-dimensional image, similar to the endoscopic view. Biliary CT simulation endoscopy technology has also begun to be used in clinical applications.  (1) Clinical application value of CTVE: ①CT simulated virtual endoscopy of the gallbladde (CTVEGB) can clearly display the normal anatomical structure in the gallbladder cavity.  ②CTVEGB can clearly show the size of gallbladder polyps, the smallest can be seen as 1.5mm×2.2mm×2.5mm, and can observe the polyp growth site, morphology, surface, base and other image changes more accurately, which is basically consistent with color ultrasound and surgical pathology.  (3) It can accurately observe the single polyp of gallbladder.  (2) The advantages of CTVE in the diagnosis of gallbladder polyp examination are more prominent, but there are also some shortcomings: ① The polyps with flat and wide base are not well displayed, and the roughness of the inner wall of gallbladder can affect the detection of small polyps.  ②Improper selection of scanning parameters, workstation post-processing techniques and thresholds can cause loss of lesions.  ③Highly influenced by respiratory motion.  ④Iodine allergy patients are not suitable for this test and are susceptible to iodine concentration of the gallbladder.