Mass-forming pancreatitis: value of contrast-enhanced ultrasonography.
OBJECTIVE
To assess the utility of contrast-enhanced ultrasonography (CEUS) with a second-generation contrast medium in the differential diagnosis between mass-forming pancreatitis and pancreatic carcinoma.


METHODS
From our radio-pathology database, we retrieved all the patients affected by mass-forming pancreatitis or pancreatic carcinoma who underwent CEUS. We evaluated the results of CEUS in the study of the 173 pancreatic masses considering the possibilities of a differential diagnosis between mass-forming pancreatitis and pancreatic tumor by identifying the "parenchymographic" enhancement during the dynamic phase of CEUS, which was considered diagnostic for mass-forming pancreatitis.


RESULTS
At CEUS, 94% of the mass-forming pancreatitis showed intralesional parenchymography. CEUS allowed diagnosis of mass-forming pancreatitis with sensitivity of 88.6%, specificity of 97.8%, positive predictive value of 91.2%, negative predictive value of 97.1%, and overall accuracy of 96%. CEUS significantly increased the diagnostic confidence in the differential diagnosis between mass-forming pancreatitis and pancreatic carcinoma, with receiver operating characteristic curve areas from 0.557 (P = 0.1608) for baseline US to 0.956 (P < 0.0001) for CEUS.


CONCLUSIONS
CEUS allowed diagnosis of mass-forming pancreatitis with diagnostic accuracy of 96%. CEUS significantly increases the diagnostic confidence with respect to basal US in discerning mass-forming pancreatitis from pancreatic neoplasm.
D'Onofrio
Mirko
M
Department of Radiology, University of Verona, Policlinico G.B. Rossi, Piazzale L.A. Scuro 37134, Verona, Italy. mirko.donofrio@univr.it
Zamboni
Giulia
G
Tognolini
Alessia
A
Malago
Roberto
R
Faccioli
Niccolo
N
Frulloni
Luca
L
Pozzi Mucelli
Roberto
R
D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D010195:Pancreatitis / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
D003287:Contrast Media