Ultrasonography of the pancreas. 2. Harmonic imaging

Hohl, C.; Schmidt, Thorsten; Honnef, Dagmar; Günther, Rolf W.; Haage, Patrick

doi:10.1007/s00261-006-9017-z

Cited by 32 publications

(23 citation statements)

References 30 publications

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“…Nonfunctioning neuroendocrine tumors present as large, well-marginated hypoechoic masses, usually easy to detect, thanks to their large size, which also justifies their tendency to contain necrosis and hemorrhage, giving them a typical inhomogeneous appearance at imaging [2,15,22].…”

Section: Ultrasoundmentioning

confidence: 99%

Neuroendocrine Neoplasms

Capelli¹,

D’Onofrio²,

Crosara³

et al. 2014

Imaging and Pathology of Pancreatic Neoplasms

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Section: Ultrasoundmentioning

confidence: 99%

Neuroendocrine Neoplasms

Capelli¹,

D’Onofrio²,

Crosara³

et al. 2014

Imaging and Pathology of Pancreatic Neoplasms

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“…In pancreatic imaging, it has been shown that THI provides an enhanced overall image quality, better lesion conspicuity and advantages in solid-cystic differentiation in comparison to the conventional BM ultrasound. [4] In previous studies THI has been proven to be superior in ultrasound of the heart, vascular system, liver, biliary system, kidneys and female pelvis because harmonic imaging show a superior image quality, fewer artifacts and better delineation of normal and pathological structures compared with B-mode ultrasound. [9][10][11][12][13] Tanka et al, [13] showed that THI was significantly better in detecting and correctly characterizing focal masses of the liver than with BM ultrasound, especially for hepatocellular carcinoma in cirrhotic parenchyma.…”

Section: Discussionmentioning

confidence: 99%

“…[4] A new approach to combat the inherent limitations of conventional ultrasound is tissue harmonic imaging. These harmonic beams are whole-numbered multiples of a fundamental frequency that are transmitted by an ultrasound probe.…”

Section: Discussionmentioning

confidence: 99%

“…The differentiation of pancreatic masses is very important for the planning of appropriate treatment. [3,4] Radiological evaluation in a suspected case of a pancreatic mass generally begins with conventional ultrasound followed by CECT abdomen or CEMR depending on clinical scenario. The limitations of transabdominal ultrasound in the diagnosis of pancreatic diseases are in cases of tumors < 10mm in diameter and in the assessment of the necrotic and ischemic areas in acute pancreatitis.…”

Section: Introductionmentioning

confidence: 99%

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Tissue Harmonic Imaging Compared with Conventional BMode Ultrasound, Biphasic CECT and Tissue Diagnosis in Evaluation of Pancreatic Masses

Devi¹,

Iqbal²,

Kang³

et al. 2018

AIMDR

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Background: Tissue harmonic imaging (THI) is a newer method that can diagnose and differentiate various types of pancreatic masses. The aim of this study was to evaluate the efficacy of tissue harmonic imaging for detection and differentiation of pancreatic masses and its comparison with conventional B-mode ultrasound, biphasic CECT abdomen and tissue diagnosis. Methods: 31 patients who presented with a suspicion of pancreatic mass clinically or radiologically were enrolled in this study. All patients underwent both conventional B-mode ultrasound abdomen and THI. Biphasic CECT abdomen was done for diagnostic reference. Pancreatic lesions were documented regarding site, size, internal architecture, and status of peri-pancreatic vessels. The USG diagnosis was compared with biphasic CECT and tissue diagnosis. Results: There was statistically significant difference between THI and conventional B-mode USG in visualization of image quality (p<0.001) and solid-cystic differentiation (SCD) (p=0.001). Taking tissue diagnosis as the standard, out of the 25 (80.6%) cases which were diagnosed as malignant on USG and biphasic CECT, 18(72%) cases were confirmed to be malignant on tissue diagnosis. There was no statistically significant difference between biphasic CECT and USG (conventional B-mode and THI) in the diagnosis of benign and malignant masses in pancreas (p=1). Conclusions: THI is superior to conventional B-mode USG in the Sonography of pancreatic masses because THI has better overall image quality, lesion conspicuity, visualization of lesion margin and fluid-solid differentiation. It should be routinely utilized as part of the diagnostic workup of patients with pancreatic masses.

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“…As a result, sometimes, the lesion can be diffi cult to identify or delineate. Harmonic US and compound techniques may improve the correct identifi cation of the margins of the tumor [ 29 ].…”

Section: Ultrasoundmentioning

confidence: 99%

Ductal Adenocarcinoma

D’Onofrio¹,

Capelli²,

Robertis³

et al. 2014

Imaging and Pathology of Pancreatic Neoplasms

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PathologyDuctal adenocarcinoma is a malignant epithelial neoplasm with glandular (ductal) differentiation, without a predominant component of any other types of carcinoma [ 7 ].Sixty to seventy percent of ductal adenocarcinomas is located in the pancreatic head, 30 % in the body and tail, and 5 % involve the whole organ. Multifocal disease has been reported as well as synchronous or metachronous carcinomas.Carcinomas of the pancreatic head tend to cause symptoms such as painless jaundice, acute pancreatitis, and epigastric pain that radiates to the back.Carcinomas of the body-tail of the pancreas often present with unexplained weight loss, back pain, or distant metastases.Sudden onset of diabetes mellitus may be the fi rst sign of pancreatic cancer. 2Carcinomas of the pancreatic head are usually diagnosed earlier and are more often resectable than carcinomas that involve the body-tail.Surgically resected carcinomas of the pancreatic head are generally signifi cantly smaller than the tumors of the body and tail (2-3 cm versus 5-7 cm, respectively). MacroscopyOn the cut surface, the tumor usually appears as a solid fi rm mass with infi ltrative, indefi nable margins, whitish color, and hard consistency.The tumor is often surrounded by a phlogistic fi brous "cuff," derived from a focal peritumoral pancreatitis, making it sometimes hard to identify the actual dimensions of the tumor, both at imaging and macroscopically.Extensive areas of hemorrhage and necrosis with cystic cavitation are uncommon, but microscopic foci are not so uncommon.Carcinomas of the pancreatic head, with the exception of those arising in the uncinate process, almost always infi ltrate both the common bile duct and Wirsung's duct, leading to a variable degree of stenosis and upstream dilation (radiological "double-duct sign"). This causes jaundice and upstream obstructive pancreatitis, which could lead to chronic pancreatitis, characterized by the presence of fi brotic or fi bro-adipous components, associated with a variable degree of acinar cells atrophy, with duct dilatation and retention cysts formation.The involvement of duodenum and/or Vater's ampulla, frequently found in the carcinomas of the pancreatic head, causes retraction of the intestinal wall, and eventually mucosal ulceration.Invasion and thrombosis of large peripancreatic vessels, such as the splenic vein, are frequently observed in bodytail carcinomas.The pathological evaluation of the retroperitoneal resection margin provides the most important information about local recurrence and patient survival. This margin is defi ned as the peripancreatic adipose tissue behind the head of the pancreas, which is located ventral and lateral, in respect to the superior mesenteric artery [ 8 -11 ].When the tumor involves the celiac trunk or the superior mesenteric artery, it is considered unresectable; so, this involvement is rarely present in surgical pathology specimens. A focal and partial, noncircumferential, adhesion of the posterior pancreatic surface to the mesenteric vein may justify ...

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Ultrasonography of the pancreas. 2. Harmonic imaging

Cited by 32 publications

References 30 publications

Neuroendocrine Neoplasms

Neuroendocrine Neoplasms

Tissue Harmonic Imaging Compared with Conventional BMode Ultrasound, Biphasic CECT and Tissue Diagnosis in Evaluation of Pancreatic Masses

Ductal Adenocarcinoma

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