Role of contrast-enhanced ultrasonography in the differential diagnosis of the pancreatic and hepatic lesions


Introduction: Contrast-enhanced ultrasonography (CEUS) is a new promising tool for the characterization of pancreatic lesions. This technique allows for highlighting the micro-vascularization of a lesion, especially with the use of second generation contrast media, characterized by harmonic responses at low acoustic pressures. Pancreatic endocrine tumors (PET)s were reported to have a peculiar behavior at CEUS, consisting of a higher enhancement compared to normal pancreas in the arterial phase and a rapid washout.

Aim(s): To evaluate the usefulness of CEUS in the differential diagnosis between PETs and non-endocrine pancreatic lesions.

Materials and methods: Fourteen consecutive patients (5M, 9F, age 18-77 yrs) with evidence of pancreatic and/or hepatic lesions at the standard imaging were enrolled. A CEUS was performed in all patients. At the basal ultrasonography, 13/14 patients had a pancreatic lesion (nine solid and four cystic, range, 1.6 – 10 cm in size) and 5/14 had hepatic lesions (single in one and multiple in four). A histological diagnosis was achieved in all cases but one with a hepatic lesion without evidence of disease within the pancreas. Histology was consistent with PET in four cases and non-endocrine tumors in nine cases (ductal adenocarcinomas in six, serous cystadenocarcinoma in one, mucinous cystadenocarcinomas in two).

Conference: 7th Annual ENETSConcerence (2010)

Presenting Author: Milone F

Authors: Milone F, Di Sarno A, Faggiano A, Farella N, Ramundo V,

Keywords: pancreatic neuroendocrine tumors, differential diagnosis, contrast-enhanced ultrasonography,

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