Differentiation of Cystic Pancreatic Lesions by Echo-enhanced Sonography with Pulse Inversion Imaging - Presentation of Case Reports

Rickes, Steffen; Randhan, W; Malfertheiner, Peter

doi:10.1055/s-2004-812907

Cited by 5 publications

(1 citation statement)

References 8 publications

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“…Consequently, a method with both high sensitivity and high specificity for tumor differentiation is needed due to the fact that tumor differentiation is essential for appropriate therapy and a favorable prognosis. The vascular patterns of pancreatic tumors have been examined in patients with cystic and solid tumors using earlier second-harmonic imaging and other contrast-enhancing techniques with promising, but also conflicting, results [6,7,10,20,29,32,38,39,40,41,42,43,44,45,46,47,48]. …”

Section: Discussionmentioning

confidence: 99%

Transabdominal Contrast-Enhanced Ultrasonography of Pancreatic Cancer

Kersting¹,

Roth²,

Bunk³

2011

Pancreatology

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Since its introduction, contrast-enhanced ultrasonography (CEUS) has significantly extended the value of ultrasonography (US). CEUS can be used to more accurately determine pancreatic lesions compared to conventional US or to characterize lesions already detectable by US. Thus, CEUS can aid in the differential diagnosis of pancreatic tumors. Using US contrast media, it is possible to visually detect microvessels in the majority of pancreatic ductal adenocarcinomas. Thus, the use of quantitatively evaluated transabdominal CEUS can help in the differentiation of patients with mass-forming pancreatitis from patients with pancreatic adenocarcinomas. In neuroendocrine pancreatic tumors, different enhancement patterns can be observed in relation to the tumor mass: larger ones show a rapid early enhancement sometimes combined with necrotic central structures, and smaller ones disclose a capillary-blush enhancement. Pseudocysts, the most widespread cystic lesions of the pancreas, are not vascularized. They do not show any signal in CEUS and remain entirely anechoic in all phases, while true cystic pancreatic tumors usually have vascularized septa and parietal nodules. In summary, CEUS is effective for differentiating solid pancreatic tumors in most cases. CEUS is safe and cost effective and can better discriminate solid from cystic pancreatic lesions, thereby directing further imaging modalities.

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