Utility of Contrast-Enhanced Transabdominal Ultrasonography to Diagnose Early Chronic Pancreatitis

Abstract

Purpose. The purpose of this study was to establish the relationship between the grade of chronic pancreatitis (CP) and pancreatic blood flow as measured by contrast-enhanced transabdominal ultrasonography (CEUS) and to diagnose early CP easily. Methods. This pilot study was conducted in 8 patients with CP, 7 patients with early CP, and 6 control participants. After injecting 0.015 mL/kg of perflubutane by manual bolus, values in one region of interest (ROI) in pancreatic parenchyma and one ROI including the superior mesenteric artery (SMA) were measured. Results. The ratio of blood flow in the SMA and pancreatic parenchyma increased with grade of CP and was significantly higher in patients with CP (5.41; 2.10–11.02) than in patients with early CP (2.46; 1.41–5.05) and control participants (2.32; 1.25–3.04) (P = 0.0279, P = 0.0142, resp.). The ratio of blood flow in the SMA and pancreatic parenchyma correlated with grade of CP (rs = 0.5904, P = 0.0048). Conclusion. The ratio of blood flow correlates with grade of CP on CEUS. This safe and convenient method may be useful to diagnose early CP.

Diagnostic Challenge in Pancreatic Sarcoidosis Using Endoscopic Ultrasonography

“…Pancreatic sarcoidosis may resemble chronic pancreatitis in the presence of fibrotic tissue. Pancreatic blood flow also decreases as pancreatic fibrosis progresses ( 10 ).…”

Contrast‐Enhanced Ultrasound for the Assessment of Pancreatic Lesions

“…A more recent study showed that the blood flow ratio between the superior mesenteric artery and the pancreatic parenchyma evaluated by CEUS correlates with the grade of chronic pancreatitis and concluded that this safe and convenient method may be useful for the early diagnose of CP [22].…”

Contrast-enhanced ultrasonography of the pancreas shows impaired perfusion in pancreas insufficient cystic fibrosis patients

“…Non-invasive measurements of pancreatic perfusion have been performed by contrast-enhanced ultrasound (CEUS) [ 1 – 5 ], perfusion Computer tomography (CT) [ 6 , 7 ] and magnetic resonance imaging (MRI) [ 8 ]. Attempts at an in-vivo reference standard have been made using hydrogen gas clearance method under laparoscopy [ 9 ] and endoscopy [ 10 ].…”

“…In the pancreas perfusion can be useful in a clinical setting such as characterizing tumours [ 2 , 15 ] and in the evaluation of other focal pancreatic lesions [ 16 ]. One study was able to demonstrate reduced perfusion in chronic pancreatitis patients compared to healthy controls [ 10 ], and attempts have been made to define perfusion changes in early chronic pancreatitis [ 5 ].…”