Echo-enhanced ultrasound with pulse inversion imaging: A new imaging modality for the differentiation of cystic pancreatic tumours.
OBJECTIVE
To describe and discuss echo-enhanced sonography in the differential diagnosis of cystic pancreatic lesions.


METHODS
The pulse inversion technique (with intravenous injection of 2.4 mL SonoVue) or the power-Doppler mode under the conditions of the 2nd harmonic imaging (with intravenous injection of 4 g Levovist) was used for echo-enhanced sonography.


RESULTS
Cystadenomas frequently showed many vessels along fibrotic strands. On the other hand, cystadenocarcinomas were poorly and chaotically vascularized. "Young pseudocysts" were frequently found to have a highly vascularised wall. However, the wall of the "old pseudocysts" was poorly vascularized. Data from prospective studies demonstrated that based on these imaging criteria the sensitivities and specificities of echo-enhanced sonography in the differentiation of cystic pancreatic masses were >90%.


CONCLUSIONS
Cystic pancreatic masses have a different vascularization pattern at echo-enhanced sonography. These characteristics are useful for their differential diagnosis, but histology is still the gold standard.
Rickes
Steffen
S
Department of Gastroenterology, Hepatology and Infectious Diseases, Leipziger Str. 44, 39120 Magdeburg, Germany. steffen. rickes@medizin.uni-magdeburg.de
Mönkemüller
Klaus
K
Malfertheiner
Peter
P
D003536:Cystadenocarcinoma / Q000000981:diagnostic imaging*; D003537:Cystadenoma / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D006801:Humans; D007089:Image Enhancement; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D010192:Pancreatic Pseudocyst / Q000000981:diagnostic imaging; D018608:Ultrasonography, Doppler