No abstract

CEH-EUS with the new Olympus prototype device successfully visualizes the microvascular pattern in pancreatic solid lesions, and may be useful for distinguishing adenocarcinomas from other pancreatic masses.

The performance of CH-EUS for the diagnosis of pancreatic adenocarcinoma was excellent. The good intra- and interobserver concordances suggest an excellent reproducibility. CH-EUS could help to guide the choice between surgery and follow-up when EUS-FNA is inconclusive.

Percutaneous aspiration of hydatid cysts of the liver was performed in 13 patients, and subsequent percutaneous drainage was performed in three of the 13. Aspiration was performed with ultrasound or computed tomographic guidance with 22-gauge to 19-gauge needles. Analysis of the aspirated specimen established the diagnosis of hydatid cysts in nine of the 13 patients. Fragments of the laminated membrane were seen in seven cases, scolices in two cases, and hooklets in two cases. In the four cases with negative results on aspiration, the diagnosis was established with surgical findings in one case and unequivocal immunologic results in three cases. In two patients, a mild allergic reaction with temporary pruritus was observed. In three patients, percutaneous drainage was performed with a 5-F to 8.3-F catheter, and sterilization of the cyst was achieved by injection of a scolicidal agent. No complications occurred at the time of drainage, and no recurrences developed during 6 months to 1 year after drainage.

Ultrasound (US) detected 27 small, asymptomatic renal angiomyolipomas in 18 patients. Twenty-five lesions were diffusely hyperechoic and 2 were heterogeneous. Nephrotomography was positive in 8 out of 12 patients (67%), CT in 12/14 (86%), and angiography in 10/14 (71%). Percutaneous fine-needle biopsy confirmed the diagnosis in 8 out of 12 patients (67%). Nephrotomography and angiography were nonspecific, whereas CT and biopsy were most specific because of the presence of fatty tissue. Angiography helped clarify the degree of vascularity of the masses. If the diagnosis can be made preoperatively, more conservative management can be undertaken.