Evaluation of contrast enhancement patterns in pancreatic tumors by coded harmonic sonographic imaging with a microbubble contrast agent.
OBJECTIVE
The purpose of the study was to assess patterns of primary pancreatic lesions by contrast-enhanced sonography for differentiating ductal carcinomas from other pancreatic tumors.


METHODS
One hundred six consecutive patients with pancreatic masses, consisting of 83 ductal carcinomas, 7 endocrine carcinomas, 5 intraductal papillary mucinous tumors, 3 cases of autoimmune-related pancreatitis, 3 solid pseudopapillary tumors, 2 cases of chronic pancreatitis, 1 serous cystadenoma, 1 osteoclastoid giant cell tumor, and 1 follicular lymphoma, were examined by contrast-enhanced sonography with coded harmonic imaging in a phase inversion harmonic technique. The contrast enhancement patterns were assessed, and specimens removed during pancreatectomy were subjected to pathologic examination.


RESULTS
Internal tumoral vascularity was detected in 47 (56.6%) of the 83 ductal carcinomas. Vascular image spreading and homogeneous staining throughout the tumors were observed in all endocrine carcinomas. Two of the 5 intraductal papillary mucinous tumors were positive for enhancement effects. Enhancement effects were observed in all 3 cases of autoimmune-related pancreatitis, but the degree varied. There was a significant correlation between the intensity of enhancement effects and the ratio of patent vessels in the tumors (P < .05).


CONCLUSIONS
Vascularity was detected by contrast-enhanced sonography in only about half of the ductal carcinomas, confirming the difficulty in distinguishing those tumors from other pancreatic tumors. There was a correlation between the patency of the vessels in the tumors and their vascularity.
Nagase
Michitaka
M
Division of Hepatobiliary Pancreatic Medical Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. mnagase@east.ncc.go.jp
Furuse
Junji
J
Ishii
Hiroshi
H
Yoshino
Masahiro
M
D000230:Adenocarcinoma / Q000000981:diagnostic imaging; D007516:Adenoma, Islet Cell / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D010195:Pancreatitis / Q000000981:diagnostic imaging; D011134:Polysaccharides; D014463:Ultrasonography
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508