Contrast-enhanced power Doppler sonography of ductal pancreatic adenocarcinomas: correlation with digital subtraction angiography findings.
OBJECTIVE
The purpose of this prospective study was to utilize contrast-enhanced power Doppler sonography to evaluate the enhancement characteristics of ductal pancreatic adenocarcinomas and correlate them with the tumor vascularity observed on digital subtraction angiography (DSA).


METHODS
Twenty consecutive patients with ductal pancreatic adenocarcinoma underwent power Doppler sonography and DSA. Tumor vascularity was assessed using unenhanced and contrast-enhanced power Doppler sonography. The contrast agent Levovist was administered intravenously by bolus injection of a dose of 2.5 g at a concentration of 350 mg/mL; saline was administered immediately thereafter. The patients were asked to hold their breath for 30 seconds (for the period 15-45 seconds after saline injection) while the early phase of enhancement was studied; the delayed phase of enhancement was observed between 60 and 120 seconds after saline administration, while patients breathed gently.


RESULTS
None of the 20 pancreatic carcinomas showed any color signals on power Doppler sonography before administration of the contrast medium. Seventeen (85%) of the 20 pancreatic carcinomas also showed no enhancement in the early and delayed phases of contrast-enhanced power Doppler sonography. However, in the early phase of contrast-enhanced power Doppler sonography; 1 lesion showed pronounced enhancement and 2 showed mild enhancement. On DSA, the 17 carcinomas showing no enhancement on power Doppler sonography were found to be hypovascular, whereas the remaining 3 carcinomas with contrast enhancement on power Doppler sonography were found to be hypervascular.


CONCLUSIONS
The enhancement characteristics of the ductal pancreatic adenocarcinomas correlated well with the tumor vascularity observed on DSA. However, further study is needed to determine the accuracy of contrast-enhanced sonography in the diagnosis of pancreatic masses.
Chen
Chien-Hua
CH
Division of Gastroenterology, Department of Internal Medicine, Show-Chwan Memorial Hospital, 542, Section 1, Chung-Shang Road, Changhua 500, Taiwan.
Yang
Chi-Chieh
CC
Yeh
Yung-Hsiang
YH
Huang
Min-Ho
MH
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D021441:Carcinoma, Pancreatic Ductal / Q000098:blood supply* / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging*; D011134:Polysaccharides; D011446:Prospective Studies; D018608:Ultrasonography, Doppler / Q000379:methods*
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508