title: The application value of contrast-enhanced ultrasound in the differential diagnosis of pancreatic solid-cystic lesions.
abstract: OBJECTIVE
  To retrospectively determine the accuracy of baseline ultrasound (BUS) and of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of pancreatic solid-cystic lesions.
  
  
  METHODS
  Fifty-four pancreatic solid-cystic lesions in 52 patients were examined with BUS and CEUS, two different seniority radiologists read the images independently, Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic value of BUS and CEUS in the diagnosis of benign or malignant pancreatic solid-cystic lesions, the diagnostic consistency between different seniority radiologists was evaluated by Kappa statistics.
  
  
  RESULTS
  Among the 54 lesions, there were pancreatic cyst five cases, pancreatic pseudocyst twenty cases, pancreatic cystadenoma eight cases, pancreatic cystadenocarcinoma seven cases, intraductal papillary mucinous neoplasm of pancreas (IPMN) three cases, pancreatic carcinoma combined liquefied six cases, solid-pseudopallary tumor of pancreas (SPTP) three cases, pancreatic myopericytoma one case, pancreatic lymphangioma one case. After ROC analysis, the areas under the ROC curve (Az) were 0.752 by BUS, 0.928 by CEUS to resident radiologist, and 0.896 by BUS, 0.954 by CEUS to staff radiologist. The correct diagnosis rate of specific disease was 42.6% by BUS, 64.8% by CEUS to staff radiologist (P<0.05), and 33.3% by BUS, 53.7% by CEUS to resident radiologist (P<0.05). The interobserver agreement in CEUS is higher than that in BUS, the Kappa value was 0.889 ± 0.062 and 0.428 ± 0.126 respectively.
  
  
  CONCLUSIONS
  Compared with BUS, CEUS can significantly enhance the diagnostic rate of pancreatic solid-cystic lesions.
authors.affiliation: Department of Medical Ultrasonics, The First Affiliated Hospital, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, 58 Zhong Shan Road 2, Guangzhou 510080, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Xu
authors.forename: Xiao-yan
authors.initials: XY
authors.lastname: Xie
authors.forename: Guang-jian
authors.initials: GJ
authors.lastname: Liu
authors.forename: Hui-xiong
authors.initials: HX
authors.lastname: Xu
authors.forename: Zuo-feng
authors.initials: ZF
authors.lastname: Xu
authors.forename: Guang-liang
authors.initials: GL
authors.lastname: Huang
authors.forename: Pei-fen
authors.initials: PF
authors.lastname: Chen
authors.forename: Jia
authors.initials: J
authors.lastname: Luo
authors.forename: Ming-de
authors.initials: MD
authors.lastname: Lü
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging; D010743:Phospholipids; D012372:ROC Curve; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride