title: Three-dimensional contrast-enhanced ultrasonography of intraductal papillary mucinous neoplasms of the pancreas: a comparison with magnetic resonance imaging.
abstract: OBJECTIVE
  The objective of this study was to prospectively compare the diagnostic accuracy of 3-dimensional contrast-enhanced ultrasonography (3D-CEUS) with that of magnetic resonance imaging (MRI) in the study of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas.
  
  
  METHODS
  Thirty consecutive patients with IPMN were studied.
  
  
  RESULTS
  Three patients (10.0%) did not undergo diagnostic 3D-CEUS because of technical problems. Three dimensional CEUS identified 12 (44.4%) main-duct IPMNs versus no cases by MRI (P < 0.001). Intraductal papillary mucinous neoplasm localization showed poor agreement between 3D-CEUS and MRI (κ = 0.058), whereas good agreement was found in detecting the pancreatic calcifications (κ = 1.000). Significant differences between 3D-CEUS and MRI were found regarding the number of lesions detected (1.4 ± 0.8 vs 3.8 ± 3.6; P < 0.001), the detection of mucinous plugs (3.7% vs 50.0%; P < 0.001), chronic pancreatitis (7.4% vs 26.7%; P = 0.031), pancreatic atrophy (0% vs 50.0%; P < 0.001), thick septa (22.2% vs 53.3%; P = 0.004), and mural nodules (25.9% vs 3.3%; P = 0.016). Three dimensional CEUS showed similar results as compared with MRI in evaluating IPMNs smaller than 1 cm of diameter or greater than 2 cm.
  
  
  CONCLUSIONS
  Even if MRI remains the criterion standard technique for the diagnosis of IPMNs, 3D-CEUS can be safely used to follow patients with IPMNs of less than 1 cm.
authors.affiliation: From the Departments of *Digestive Diseases and Internal Medicine, †Radiology, and ‡Surgery, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Pezzilli
authors.forename: Carla
authors.initials: C
authors.lastname: Serra
authors.forename: Lucia
authors.initials: L
authors.lastname: Calculli
authors.forename: Fabio
authors.initials: F
authors.lastname: Ferroni
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Iammarino
authors.forename: Riccardo
authors.initials: R
authors.lastname: Casadei
mesh_terms: D000368:Aged; D049448:Cholangiopancreatography, Magnetic Resonance; D003287:Contrast Media; D018291:Cystadenoma, Mucinous / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D010743:Phospholipids; D013459:Sulfur Hexafluoride; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride