《美国超声放射医师学会胆囊息肉管理共识(2022)》解读

Interpretation of the American Society of Ultrasound Radiologists Consensus on the Management of Incidentally Detected Gallbladder Polyps(2022)

2021年美国超声放射医师学会召集胆囊研究领域的多学科专家(放射科、外科、病理科、胃肠病学、超声科等),基于循证医学证据,根据胆囊息肉的形态学特征将胆囊息肉分为“极低风险”、“低风险”与“不确定风险”3个类别,“极低风险”表现为球-壁相连或有细蒂,“低风险”表现为宽蒂、宽基底或无蒂,“不确定风险”类别为息肉连接处胆囊壁处局灶增厚(≥4 mm)。《美国超声放射医师学会胆囊息肉管理共识(2022)》综合息肉生长速度与最大直径提出了胆囊息肉的管理建议,“极低风险”及“低风险”类别息肉直径>15 mm为手术阈值,“不确定风险”类别直径>7 mm为手术阈值,另外息肉1年内直径增大4 mm及以上亦为手术指征;<9 mm的“极低风险”或<6 mm的“低风险”类别息肉无须随访;其余情况建议对息肉进行3年随访。

Experts in gallbladder disease in the field of radiology,surgery,pathology,gastroenterology,sonography were organized to make a consensus of gallbladder polyps by the American Society of Radiologists in Ultrasound in 2021.Consensus conference committee divided gallbladder polyps into extremely low risk,low risk,and indeterminate risk lesions according to the morphological characteristics of gallbladder polyps."Extremely low risk"is characterized by ball-on-wall or thin pedicle,while"low risk"is characterized by a wide stalk or sessile.The"uncertain risk"category was focal thickening(≥4 mm)of the gallbladder wall at the polyp junction.The"Consensus"proposed the management suggestions for gallbladder polyps based on the growth rate and maximum diameter of polyps.The"extremely low risk"and"low risk"categories of polyps whose diameter exceeded 15 mm were the surgical threshold,and the"uncertain risk"category whose diameter exceeded 7 mm was the surgical threshold.In addition,the diameter of polyps increased by 4 mm or more within one year was also the indication for surgery."Extremely low risk"polyps diameter less than 9 mm or"low risk"less than 6 mm do not require follow-up.In other cases,3-year follow-up is recommended for polyps.