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KMID : 1188320130070050599
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Gut and Liver
2013 Volume.7 No. 5 p.599 ~ p.604
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Clinical Role of Contrast-Enhanced Harmonic Endoscopic Ultrasound in Differentiating Solid Lesions of the Pancreas: A Single-Center Experience in Korea
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Lee Tae-Yoon
Cheon Young-Koog
Shim Chan-Sup
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Abstract
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Background/Aims:The differential diagnosis of pancreatic solid lesions remains challenging. The aim of this study was to investigate the accuracy of contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS) in differentiating pancreatic cancer from benign lesions.
Methods:We prospectively evaluated 37 patients with pancreatic solid lesions. After intravenous injection of a contrast agent (SonoVue), CEH-EUS was performed using a radial echoendoscope. Pancreatic solid lesions were classified into three vascular patterns (hyperintense, isointense, and hypointense) on the basis of CEH-EUS imaging, and these patterns were compared to the histological diagnosis.
Results:The lesions were hypervascular (n=6), isovascular (n=3), or hypovascular (n=28). Histological diagnosis was confirmed by EUS-FNA in 26 patients (22 adenocarcinomas, two focal pancreatitis, one pancreatic neuroendocrine tumor [NET], and one pancreatic tuberculosis); by surgery in 10 patients (four adenocarcinomas, three pancreatic NETs, two invasive intraductal papillary mucinous neoplasms, and one acinar cell carcinoma); and by both methods in one patient. Among pancreatic carcinomas, 28 out of 30 lesions (93%) had persistent hypovascular signals in the early and late phase, which indicates a sensitivity and diagnostic accuracy of 93% and 92%, respectively for the diagnosis of pancreatic cancer.
Conclusions:CEH-EUS was useful for characterization of pancreatic solid masses with high sensitivity and accuracy.
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KEYWORD
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Pancreatic neoplasms, Endosonography, Contrast-enhanced
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