Clin Ultrasound.  2016 Nov;1(2):84-91. 10.18525/cu.2016.1.2.84.

Clinical Efficacy of Contrast-Enhanced Endoscopic Ultrasound in the Pancreatic Solid Lesions

• Seo JW
• Lee TY
• Cheon YK
• Shim CS

• KMID: 2555384
• DOI: http://doi.org/10.18525/cu.2016.1.2.84

Abstract

Background/Aims
The differential diagnosis of pancreatic solid lesions remains challenging. The aim of this study was to investigate the accuracy of contrast-enhanced endoscopic ultrasound (CEH-EUS) in differentiating pancreatic cancer from benign lesions.
Methods
We prospectively evaluated 37 patients with pancreatic solid lesions. After intravenous injection of a contrast agent (SonoVue), CEH-EUS was performed using a radial echoendoscope. Pancreatic solid lesions were classified into three vascular patterns (hyperintense, isointense, and hypointense) on the basis of CEH-EUS imaging, and these patterns were compared to the histological diagnosis.
Results
The lesions were hypervascular (n = 6), isovascular (n = 3), or hypovascular (n = 28). Histological diagnosis was confirmed by EUSfine needle aspiration in 26 patients (22 adenocarcinomas, 2 focal pancreatitis, 1 pancreatic neuroendocrine tumor [NET], and 1 pancreatic tuberculosis); by surgery in 10 patients (4 adenocarcinomas, 3 pancreatic NETs, 2 invasive intraductal papillary mucinous neoplasms, and 1 acinar cell carcinoma); and by both methods in one patient. Among pancreatic carcinomas, 28 out of 30 lesions (93%) had persistent hypovascular signals in the early and late phase, which indicates a sensitivity and diagnostic accuracy of 93% and 92%, respectively for the diagnosis of pancreatic cancer.
Conclusions
CEH-EUS was useful for characterization of pancreatic solid masses with high sensitivity and accuracy.

Keyword

췌장 고형성 병변; 내시경 초음파; 조영증강; Pancreatic neoplasm; Endosonography; Contrast agents