Published online Apr 14, 2006. doi: 10.3748/wjg.v12.i14.2205
Revised: August 10, 2005
Accepted: August 26, 2005
Published online: April 14, 2006
AIM: To describe and discuss echo-enhanced sonography in the differential diagnosis of cystic pancreatic lesions.
METHODS: The pulse inversion technique (with intravenous injection of 2.4 mL SonoVue®) or the power-Doppler mode under the conditions of the 2nd harmonic imaging (with intravenous injection of 4 g Levovist®) was used for echo-enhanced sonography.
RESULTS: Cystadenomas frequently showed many vessels along fibrotic strands. On the other hand, cystadenocarcinomas were poorly and chaotically vascularized. ”Young pseudocysts” were frequently found to have a highly vascularised wall. However, the wall of the ”old pseudocysts” was poorly vascularized. Data from prospective studies demonstrated that based on these imaging criteria the sensitivities and specificities of echo-enhanced sonography in the differentiation of cystic pancreatic masses were > 90%.
CONCLUSION: Cystic pancreatic masses have a different vascularization pattern at echo-enhanced sonography. These characteristics are useful for their differential diagnosis, but histology is still the gold standard.