Dynamic quantitative evaluation of contrast-enhanced endoscopic ultrasonography in the diagnosis of pancreatic diseases.

Abstract

OBJECTIVES:

This study aimed to investigate the usefulness of contrast-enhanced endoscopic ultrasonography (EUS) with time-intensity curve (TIC) in differentiating pancreatic diseases.

METHODS:

Patients who underwent contrast-enhanced EUS between January 2007 and June 2009 were analyzed retrospectively, including 48 with pancreatic ductal cancer (PC), 14 with autoimmune pancreatitis (AIP), 13 with mass-forming pancreatitis (MFP), and 16 with pancreatic endocrine tumor (PET). After intravenous injection of contrast agent, contrast imaging pattern, TIC-based quantitative evaluation, and diagnostic ability of EUS in combination with TIC to diagnose benignancy or malignancy were assessed.

RESULTS:

Hypovascular and heterogeneous pattern (42/48) in PC, isovascular and homogenous (21/27) in AIP and MFP, and hypervascular and rapid stained (16/16) in PET were observed. The echo intensity reduction rate from the peak at 1 minute was the greatest in PC followed by MFP, AIP, and PET (P < 0.05). The diagnostic accuracies based on contrast imaging pattern (84.0%) and TIC (88.0%) were higher than those based on B-mode imaging (82.6%) and dynamic computed tomography (81.3%). In EUS in combination with TIC, sensitivity, specificity, and accuracy rose up to 95.8%, 92.6%, and 94.7%, respectively.

CONCLUSIONS:

Contrast-enhanced EUS with the dynamic quantitative analysis preparing TIC increased the diagnostic accuracy for pancreatic diseases.

• Authors: Hiroshi Matsubara, Akihiro Itoh, Hiroki Kawashima, Toshifumi Kasugai, Eizaburo Ohno, Takuya Ishikawa, Yuya Itoh, Yosuke Nakamura, Takeshi Hiramatsu, Masanao Nakamura, Ryoji Miyahara, Naoki Ohmiya, Masatoshi Ishigami, Yoshiaki Katano, Hidemi Goto, Yoshiki Hirooka
• Journal: Pancreas (Pancreas) Vol. 40 Issue 7 Pg. 1073-9 (Oct 2011) ISSN: 1536-4828 [Electronic] United States
• PMID: 21633317 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Contrast Media
• Ferric Compounds
• Oxides
• Sonazoid
• Iron

Topics

• Adult
• Aged
• Aged, 80 and over
• Analysis of Variance
• Autoimmune Diseases (diagnostic imaging)
• Carcinoma, Pancreatic Ductal (diagnostic imaging, pathology)
• Contrast Media
• Diagnosis, Differential
• Endosonography
• Female
• Ferric Compounds
• Humans
• Iron
• Japan
• Male
• Middle Aged
• Oxides
• Pancreatic Diseases (diagnostic imaging, pathology)
• Pancreatic Neoplasms (diagnostic imaging, pathology)
• Pancreatitis (diagnostic imaging)
• Predictive Value of Tests
• ROC Curve
• Retrospective Studies
• Time Factors