title: Vascular patterns in nodules of intraductal papillary mucinous neoplasms depicted under contrast-enhanced ultrasonography are helpful for evaluating malignant potential.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the feasibility of contrast-enhanced ultrasonography (CE-US) to differentiate between benign and malignant intraductal papillary mucinous neoplasms (IPMN).
  
  
  METHODS
  Contrast-enhanced ultrasonography with a contrast agent was performed on 22 consecutive patients with IPMN suspected of being malignant. This revealed 10 carcinomas, 1 borderline lesion and 11 adenomas. All patients underwent surgery, and the histological diagnosis was confirmed by examination of resected specimens. CE-US was performed using a contrast agent. The detection rates of mural nodules were compared between CE-US and contrast-enhanced computed tomography (CE-CT), and the imaging of mural nodules depicted under CE-US was analyzed.
  
  
  RESULTS
  Seventeen of 22 resected specimens (77.3%) had mural nodules. There was no significant difference in the detection rate between CE-US (n=15; 88.2%) and CE-CT (n=12; 70.6%). In 12 (80.0%) of these patients, CE-US revealed small vessels in the mural nodule. The spotty or linear-shaped pattern was detected in 4 patients and the branch-shaped pattern in 8. The branch-shaped pattern lesion was associated with carcinoma. These mural nodules were 10mm or more in height. In the perfusion image phase, cystic walls and mural nodules were also enhanced in all cases.
  
  
  CONCLUSIONS
  The vessel shapes of the mural nodules depicted under CE-US were associated with size and pathological findings. These results suggested that CE-US with a contrast agent is a powerful modality with which to evaluate the malignant potential of IPMN.
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine and Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama-city, Okayama 700-8558, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Kurihara
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kawamoto
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Koichiro
authors.initials: K
authors.lastname: Tsutsumi
authors.forename: Masakuni
authors.initials: M
authors.lastname: Fujii
authors.forename: Hironari
authors.initials: H
authors.lastname: Kato
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D001940:Breast / Q000098:blood supply*; D001943:Breast Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging* / Q000209:etiology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*
chemical_list: D003287:Contrast Media