title: Contrast enhanced ultrasound in the pathology of the pancreas - a monocentric experience.
abstract: The
  
  
  OBJECTIVE
  of this study was to summarize the spectrum of pancreatic pathology assessed by contrast enhanced ultrasound (CEUS) in a single Gastroenterology Center and to emphasize its accuracy in assessing two of the most important pancreatic lesions: solid tumors and necrotic lesions in acute pancreatitis.
  
  
  METHODS
  Our retrospective study included 197 patients with pancreatic lesions (de novo pancreatic masses; acute, severe pancreatitis; other pathologies) evaluated by CEUS from October 2009 to May 2013, in which a reference method (contrast CT/MRI) was available.
  
  
  RESULTS
  A conclusive diagnosis was established according to the EFSUMB Guidelines in 87.8% of the 197 cases. In 87.3% cases there was a perfect concordance between CEUS and the reference method (contrast CT/MRI). 95 examinations were made for pancreatic solid masses: 41.1% (39) were hypoenhanced, 34.7% (33) were hyperenhanced, and 20% (19) were isoenhancing - chronic pancreatitis and autoimmune pancreatitis - while in 4.2% (4) cases CEUS was inconclusive. 60 examinations were made in severe acute pancreatitis and in 50% (30) cases pancreatic necrosis was diagnosed. 42 examinations were performed for other lesions: 64.2% (27) pancreatic pseudocysts, 11.9% (5) cystic tumors, 23.8% (10) other pathologies (abscesses, fibrosis, etc). CEUS accuracy for solid tumors was 92.9%. For necrotic lesions the accuracy was 97.4%.
  
  
  CONCLUSIONS
  CEUS has turned to be a good method for the characterization of different pancreatic pathologies and for evaluating acute pancreatitis. CEUS was conclusive in 90% cases and it should be considered as a first line imaging method in clinical practice.
authors.affiliation: Department of Gastroenterology and Hepatology,"Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania. roxanasirli@gmail.com.
authors.forename: Melania
authors.initials: M
authors.lastname: Ardelean
authors.affiliation: Department of Gastroenterology and Hepatology,"Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Roxana
authors.initials: R
authors.lastname: Şirli
authors.affiliation: Department of Gastroenterology and Hepatology,"Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Ioan
authors.initials: I
authors.lastname: Sporea
authors.affiliation: Department of Gastroenterology and Hepatology,"Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Simona
authors.initials: S
authors.lastname: Bota
authors.affiliation: Department of Gastroenterology and Hepatology,"Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Alina
authors.initials: A
authors.lastname: Martie
authors.affiliation: Department of Gastroenterology and Hepatology,"Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Alina
authors.initials: A
authors.lastname: Popescu
authors.affiliation: Department of Gastroenterology and Hepatology,"Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Mirela
authors.initials: M
authors.lastname: Dănila
authors.affiliation: Department of Informatics and Biostatistics, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Timar
authors.affiliation: Department of Internal Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Roxana
authors.initials: R
authors.lastname: Buzas
authors.affiliation: Department of Internal Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Daniel
authors.initials: D
authors.lastname: Lighezan
mesh_terms: D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging*; D010195:Pancreatitis / Q000000981:diagnostic imaging*; D010743:Phospholipids; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride