Improved characterisation of solitary solid pancreatic tumours using contrast enhanced transabdominal ultrasound.
BACKGROUND
Contrast enhanced ultrasound (CEUS) is a new imaging method for detection and characterisation of liver tumours. The role of CEUS in pancreatic disease is less obvious. We prospectively evaluated CEUS for characterization of undetermined solid pancreatic lesions (gold standard histology).


METHODS
A total of 112 solitary undetermined pancreatic masses (70 ductal adenocarcinoma and 42 neoplastic nodules of other origin) were prospectively examined in patients without metastatic disease using transabdominal ultrasound. Tumour enhancing features were analyzed in comparison to the surrounding pancreatic parenchyma in patients with adequate visualisation.


RESULTS
The sign of iso-hypervascularity as a sign of non-ductal adenocarcinoma showed a sensitivity of 100%, specifity of 90% and accuracy of 93.8%. The sign of hypovascularity as a sign of ductal adenocarcinoma showed a sensitivity of 90%, specifity of 100% and an accuracy of 93.8%.


CONCLUSIONS
CEUS allows differential diagnosis of ductal adenocarcinoma and non-ductal adenocarcinoma (mainly neuroendocrine tumours and (microcystic) serous pancreatic adenoma) in the most of cases.
Dietrich
C F
CF
Medical and Imaging Department, Caritas-Krankenhaus, Innere Medizin 2, Caritaskrankenhaus Bad Mergentheim, Uhlandstr. 7, 97980 Bad Mergentheim, Germany. christoph.dietrich@ckbm.de
Braden
B
B
Hocke
M
M
Ott
M
M
Ignee
A
A
D000005:Abdomen / Q000000981:diagnostic imaging*; D000230:Adenocarcinoma / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003937:Diagnosis, Differential; D019160:Endosonography; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008223:Lymphoma / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D011446:Prospective Studies
D003287:Contrast Media