title: Differentiation of branch duct intraductal papillary mucinous neoplasms from serous cystadenomas of the pancreas using contrast-enhanced sonography.
abstract: OBJECTIVE
  The purpose of this study was to determine whether contrast-enhanced sonography can improve the ability to differentiate branch duct intraductal mucinous neoplasms from serous cystadenomas of the pancreas compared to conventional (unenhanced) sonography alone.
  
  
  METHODS
  Between March 2008 and May 2012, there were 20 patients with branch duct intraductal mucinous neoplasms and 25 with serous cystadenomas in our institute, for whom preoperative conventional and contrast-enhanced sonographic results were available. The final diagnosis was obtained by histopathology. Various conventional and contrast-enhanced sonographic characteristics were retrospectively evaluated by 2 radiologists in consensus. A receiver operating characteristic curve analysis was used to evaluate the diagnostic value of conventional and contrast-enhanced sonography for discriminating between the two entities.
  
  
  RESULTS
  Three conventional sonographic characteristics (microcysts, cysts with internal echoes, and main pancreatic duct dilatation) and 2 contrast-enhanced sonographic characteristics (communication between the lesion and main pancreatic duct and enhancement of mural nodules) significantly improved the ability to differentiate branch duct intraductal mucinous neoplasms from serous cystadenomas. The area under the receiver operating characteristic curve increased from 0.691 with conventional sonography to 0.859 with combined contrast-enhanced and conventional ultrasonography (P = .043).
  
  
  CONCLUSIONS
  In this series of patients, the addition of contrast-enhanced sonography to conventional sonography improved the ability to differentiate branch duct intraductal mucinous neoplasms from serous cystadenomas.
authors.affiliation: Hepatobiliary and Pancreatic Intervention Center, First Affiliated Hospital, College of Medicine, Zhejiang University, 310003 Hangzhou, China. tiananjiang@hzcnc.com.
authors.forename: Fen
authors.initials: F
authors.lastname: Chen
authors.forename: Jun-ying
authors.initials: JY
authors.lastname: Liang
authors.forename: Qi-yu
authors.initials: QY
authors.lastname: Zhao
authors.forename: Li-yin
authors.initials: LY
authors.lastname: Wang
authors.forename: Ju
authors.initials: J
authors.lastname: Li
authors.forename: Zhuang
authors.initials: Z
authors.lastname: Deng
authors.forename: Tian-an
authors.initials: TA
authors.lastname: Jiang
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging*; D000231:Adenocarcinoma, Papillary / Q000000981:diagnostic imaging*; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging*; D003287:Contrast Media; D018293:Cystadenoma, Serous / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D010743:Phospholipids; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
keywords: contrast-enhanced sonography; gastrointestinal ultrasound; intraductal papillary mucinous neoplasm; receiver operating characteristic analysis; serous cystadenoma