title: Application of contrast-enhanced ultrasound in the diagnosis of solid pancreatic lesions--a comparison of conventional ultrasound and contrast-enhanced CT.
abstract: OBJECTIVE
  To explore the diagnostic value of contrast-enhanced ultrasound (CEUS) by comparison with conventional ultrasound (US) and contrast-enhanced CT (CECT) in solid pancreatic lesions.
  
  
  METHODS
  Ninety patients with solid pancreatic focal lesions were enrolled, including 36 cases of pancreatic carcinoma, 28 cases of pancreatitis, 6 cases of pancreatic neuroendocrine tumor, 12 cases of solid pseudopapillary tumor of the pancreas, 6 cases of pancreatic metastases, 1 case of cavernous hemolymphangioma and 1 case of lymphoma. US and CEUS were applied respectively for the diagnosis of a total of 90 cases of solid pancreatic lesions. The diagnostic results were scored on a 5-point scale. Results of CEUS were compared with CECT.
  
  
  RESULTS
  (1) 3-score cases (undetermined) diagnosed by CEUS were obviously fewer than that of US, while the number of 1-score (definitely benign) and 5-score (definitely malignant) cases diagnosed by CEUS was significantly more than that of US. There was a significant difference in the distribution of final scores using the two methods (p<0.001). The overall diagnostic accuracies of the 90 cases for CEUS and US were 83.33% and 44.44%, respectively, which indicated an obvious advantage for CEUS (p<0.001). (2) The diagnostic consistency among three ultrasound doctors: the kappa values calculated for US were 0.537, 0.444 and 0.525, compared with 0.748, 0.645 and 0.795 for CEUS. The interobserver agreement for CEUS was higher than that for US. (3) The sensitivity, specificity and accuracy of the diagnosis of pancreatic carcinoma with CEUS and CECT were 91.7% and 97.2%, 87.0% and 88.9%, and 88.9% and 92.2%, respectively, while for the diagnosis of pancreatitis, the corresponding indices were 82.1% and 67.9%, 91.9% and 100%, and 88.9% and 90%, respectively, showing no significant differences (p>0.05).
  
  
  CONCLUSIONS
  CEUS has obvious superiority over conventional US in the general diagnostic accuracy of solid pancreatic lesions and in the diagnostic consistency among doctors. The performances of CEUS are similar to that of CECT in the diagnosis of pancreatic carcinoma and focal pancreatitis.
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Ultrasound, Peking University Cancer Hospital & Institute, No. 52, Fucheng Road, Haidian District, Beijing 100142, China. fanzhihui_1026@163.com
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Fan
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.forename: Kun
authors.initials: K
authors.lastname: Yan
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
authors.forename: Shanshan
authors.initials: S
authors.lastname: Yin
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
authors.forename: Baocai
authors.initials: B
authors.lastname: Xing
authors.forename: Xiaoting
authors.initials: X
authors.lastname: Li
authors.forename: Xiaopeng
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D010743:Phospholipids; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D007472:Iohexol; D013459:Sulfur Hexafluoride
keywords: Contrast-enhanced CT; Contrast-enhanced ultrasound; Pancreas; Tumor