Application of Contrast-Enhanced Ultrasound in Cystic Pancreatic Lesions Using a Simplified Classification Diagnostic Criterion

Objective. Classification diagnosis was performed for cystic pancreatic lesions using ultrasound (US) and contrast-enhanced ultrasound (CEUS) to explore the diagnostic value of CEUS by comparison with enhanced CT. Methods. Sixty-four cases with cystic pancreatic lesions were included in this study. The cystic lesions of pancreas were classified into four types by US, CEUS, and CT: type I unilocular cysts; type II microcystic lesions; type III macrocystic lesions; and type IV cystic lesions with solid components or irregular thickening of the cystic wall or septa. Results. Eighteen type I, 7 type II, 10 type III, and 29 type IV cases were diagnosed by CT. The classification results by US were as follows: 6 type I; 5 type II; 4 type III; and 49 type IV cases. Compared with the results by enhanced CT, the kappa value was 0.36. Using CEUS, 15, 6, 12, and 31 cases were diagnosed as types I–IV, respectively. The kappa value was 0.77. Conclusion. CEUS has obvious superiority over US in the classification diagnostic accuracy in cystic pancreatic lesions and CEUS results showed substantial agreement with enhanced CT. CEUS could contribute to the differential diagnosis of cystic pancreatic diseases.

[1]  C. Iancu,et al.  Contrast enhanced ultrasound and computer tomography diagnosis of solid and mixed pancreatic tumors - analysis of confounders. , 2012, Journal of gastrointestinal and liver diseases : JGLD.

[2]  Hui-Xiong Xu,et al.  The application value of contrast-enhanced ultrasound in the differential diagnosis of pancreatic solid-cystic lesions. , 2012, European journal of radiology.

[3]  C. Iancu,et al.  Added value of intravenous contrast-enhanced ultrasound for characterization of cystic pancreatic masses: a prospective study on 37 patients. , 2012, Medical ultrasonography.

[4]  C. Dietrich,et al.  Pancreatic multicenter ultrasound study (PAMUS). , 2012, European journal of radiology.

[5]  K. Yan,et al.  Role of contrast-enhanced ultrasound in diagnosis of pancreatic solid pseudopapillary tumor , 2010 .

[6]  A. Ignee,et al.  Contrast enhanced transabdominal ultrasound in the characterisation of pancreatic lesions with cystic appearance. , 2010, JOP : Journal of the pancreas.

[7]  A. Megibow,et al.  Comparison of contrast-enhanced sonography and MRI in displaying anatomic features of cystic pancreatic masses. , 2007, AJR. American journal of roentgenology.

[8]  C. Thng,et al.  Pancreatic cysts: a proposed management algorithm based on current evidence. , 2007, American journal of surgery.

[9]  S. Chari,et al.  International Consensus Guidelines for Management of Intraductal Papillary Mucinous Neoplasms and Mucinous Cystic Neoplasms of the Pancreas , 2006, Pancreatology.

[10]  D. Sahani,et al.  Pancreatic cysts 3 cm or smaller: how aggressive should treatment be? , 2006, Radiology.

[11]  D. Sahani,et al.  Cystic pancreatic lesions: a simple imaging-based classification system for guiding management. , 2005, Radiographics : a review publication of the Radiological Society of North America, Inc.

[12]  S. Saini,et al.  Imaging diagnosis of cystic pancreatic lesions: pseudocyst versus nonpseudocyst. , 2005, Radiographics : a review publication of the Radiological Society of North America, Inc.

[13]  S. Rickes,et al.  Differentiation of cystic pancreatic neoplasms and pseudocysts by conventional and echo‐enhanced ultrasound , 2004, Journal of gastroenterology and hepatology.

[14]  C. Bassi,et al.  Management of 100 Consecutive Cases of Pancreatic Serous Cystadenoma: Wait for Symptoms and See at Imaging or Vice Versa? , 2003, World Journal of Surgery.

[15]  G. Klöppel,et al.  Cystic Lesions and Neoplasms of the Pancreas , 2001, Pancreatology.

[16]  D. Hough,et al.  Incidentally Discovered Pancreatic Cysts The Natural History of the Incidentally Discovered Small Simple Pancreatic Cyst : Long-Term Follow-Up and Clinical Implications , 2004 .

[17]  G. Klöppel,et al.  Cystic lesions and neoplasms of the pancreas. The features are becoming clearer. , 2001, Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.].