Contrast enhanced EUS in differential diagnosis of pancreatic tumor / 中华消化内镜杂志

ABSTRACT

Objective To evaluate contrast-enhanced endoscopic uhrasonography(CE-EUS)in the differential diagnosis of pancreatic diseases.Methods Eighteen patients with suspected pancreatic neoplasms and chronic pancreatitis,which would be finally affirmed with EUS-FNA or histophathologic examinations,as well as five normal control subjects were enrolled and underwent CE-EUS by using ultrasonic contrast agent(sonovue,Bracco Co.,Italy).Characteristics of enhancement including form,echo and enhanced blood perfusion of the target areas were investigated in normal pancreas and various diseased ones.Results By CE-EUS,five cases of normal pancreatic parenchyma were presented as punctiform or claviform enhancement pattern with homogeneous distribution(type Ⅰ-Ⅱ);while two chronic pancreatitis cases were presented as claviform or plaquelike enhancement pattern with inhomogeneous distributition(type Ⅱ-Ⅲ).In addition,thirteen pancreatic carcinomas were presented as inhomogeneous punctiform or claviform enhancement(typeⅠ-Ⅱ)partially with border enhancement and with slow enter-in and fast wash-out phase.However,three benign insulinomas were presented as holo-plaquelike enhancement(type Ⅲ),and 2 with fast enter-in and fast washout phase.Besides,different enhancement intensity was identified in different diseases.Conclusion CEEUS,from which different enhancement pattern,phase and intensity would be shown in various pancreas,is a safe and feasible imaging modality in the differential diagnosis of pancreatic diseases.