Contrast-Enhanced Ultrasonography of the Pancreas

Pancreaticoduodenectomy for pancreatic cancer: The Verona experience

“…The use of CEUS may add some value to the regional staging of PDAC through the dynamic evaluation of pancreas perfusion and the high accuracy in detecting vascular infi ltration or encasement by the neoplasm. 11 Moreover, the late hepatic contrast-enhanced phase is highly sensitive and specifi c for the identifi cation and characterization of liver metastases. 11 Despite the high-quality preoperative staging and an oncologically adequate PD, a substantial proportion of patients (up to 30%) recur very early and eventually die of disease within 1 year of surgery.…”

“…11 Moreover, the late hepatic contrast-enhanced phase is highly sensitive and specifi c for the identifi cation and characterization of liver metastases. 11 Despite the high-quality preoperative staging and an oncologically adequate PD, a substantial proportion of patients (up to 30%) recur very early and eventually die of disease within 1 year of surgery. The basis of this phenomenon is poorly understood and may be due to particularly aggressive subtypes of PDAC.…”

Contrast-enhanced ultrasound of the pancreas

“…Unfortunately, in the literature there are no studies comparing CEUS with CT or MRI in the evaluation and follow-up of acute pancreatitis. At this moment, CT remains more effective than CEUS, in particular in grading the stage of the disease [18] . Pseudocysts: Pseudocysts can be sequelae of severe acute pancreatitis or can occur in chronic pancreatitis [18] .…”

“…At this moment, CT remains more effective than CEUS, in particular in grading the stage of the disease [18] . Pseudocysts: Pseudocysts can be sequelae of severe acute pancreatitis or can occur in chronic pancreatitis [18] . Characterized by a fibrous wall without an epithelial lining [19] , pseudocysts must be differentiated from pancreatic cystic tumors, especially mucinous cystadenomas (MCAs), as they require completely different therapeutic approaches [19] .…”

“…Loco-regional US staging of ductal adenocarcinoma is very accurate [20] and after the administration of microbubbles both margins and size of the lesion are more visible, improving the detection of vascular infiltration or involvement. In addition, CEUS improves hepatic staging, allowing a higher accuracy in the detection and characterization of distant metastases [18] . Endocrine tumors: Endocrine tumors arise from the neuroendocrine cells of the pancreas and may induce specific clinical syndrome related to the tumor-released hormones (clinically classified as functioning endocrine tumors), or aspecific symptoms resulting from the expansive growth and tumor size [clinically classified as nonfunctioning endocrine tumors (NFETs)] [19,29] .…”