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European Radiology

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30.10.2021 | Ultrasound

Clinical value of contrast-enhanced ultrasound enhancement patterns for differentiating solid pancreatic lesions

verfasst von: Yanjie Wang, Guanghan Li, Kun Yan, Zhihui Fan, Rong Long, Jun Shan, Ying Dai, Wei Wu

Erschienen in: European Radiology | Ausgabe 3/2022

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Abstract

Objectives

To explore the diagnostic value of contrast-enhanced ultrasound (CEUS) enhancement patterns for differentiating solid pancreatic lesions and compare them with conventional ultrasound (US) and enhanced computed tomography (CT).

Methods

A total of 210 patients with solid pancreatic lesions who had definite pathological or clinical diagnoses were enrolled. Six CEUS enhancement patterns were proposed for solid pancreatic lesions. Two US doctors blindly observed the CEUS patterns of solid pancreatic lesions and the interrater agreement was analyzed. The diagnostic value of CEUS enhancement patterns for differentiating solid pancreatic lesions was evaluated, and the diagnostic accuracy was compared with that of US and enhanced CT.

Results

There was good concordance for six CEUS enhancement patterns of solid pancreatic lesions between the two doctors, with a kappa value of 0.767. Hypo-enhancement (Hypo-E) or centripetal enhancement (Centri-E) as the diagnostic criteria for pancreatic carcinoma had an accuracy of 87.62%; hyper-enhancement (Hyper-E) for neuroendocrine tumors had an accuracy of 92.89%; capsular enhancement with low or uneven enhancement inside the tumor (Capsular-E) for solid pseudopapillary tumors had an accuracy of 97.63%; and iso-enhancement (Iso-E) or iso-enhancement with focal hypo-enhancement (Iso-fhypo-E) for focal pancreatitis had an accuracy of 89.10%. The diagnostic accuracy of CEUS was significantly different from that of US for 210 cases of solid pancreatic lesions (p < 0.05) and was not significantly different from that of enhanced CT for 146 cases of solid pancreatic lesions (p > 0.05).

Conclusions

The different enhancement patterns of solid pancreatic lesions on CEUS were clinically valuable for differentiation.

Key Points

• Six CEUS enhancement (E) patterns, including Hyper-E, Iso-E, Iso-fhypo-E, Hypo-E, Centri-E, and Capsular-E, are proposed for the characterization of solid pancreatic lesions.

• Using Hypo-E or Centri-E as the diagnostic criteria for pancreatic carcinoma, Hyper-E for neuroendocrine tumors, Capsular-E for solid pseudopapillary tumors, and Iso-E or Iso-fhypo-E for focal pancreatitis on CEUS had relatively high diagnostic accuracy.

• The diagnostic accuracy of CEUS was greatly increased over that of US and was not different from that of enhanced CT.

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Titel: Clinical value of contrast-enhanced ultrasound enhancement patterns for differentiating solid pancreatic lesions
verfasst von: Yanjie Wang
Guanghan Li
Kun Yan
Zhihui Fan
Rong Long
Jun Shan
Ying Dai
Wei Wu
Publikationsdatum: 30.10.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 3/2022
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-021-08243-8

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Clinical value of contrast-enhanced ultrasound enhancement patterns for differentiating solid pancreatic lesions

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Neu im Fachgebiet Radiologie

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

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Quantitative Angiografie könnte IVUS-Alternative darstellen

Update Radiologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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