Clinical Research
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 14, 2006; 12(14): 2205-2208
Published online Apr 14, 2006. doi: 10.3748/wjg.v12.i14.2205
Echo-enhanced ultrasound with pulse inversion imaging: A new imaging modality for the differentiation of cystic pancreatic tumours
Steffen Rickes, Klaus Mönkemüller, Peter Malfertheiner
Steffen Rickes, Klaus Mönkemüller, Peter Malfertheiner, Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke-University, Magdeburg, Germany
Correspondence to: Steffen Rickes, PD Dr, Otto-von-Guericke-University Magdeburg, Department of Gastroenterology, Hepatology and Infectious Diseases, Leipziger Str. 44, 39120 Magdeburg, Germany. steffen. rickes@medizin.uni-magdeburg.de
Telephone: +49-39-16713100 Fax: +49-39-16713105
Received: July 21, 2005
Revised: August 10, 2005
Accepted: August 26, 2005
Published online: April 14, 2006
Abstract

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.

Keywords: Cystic pancreatic lesions; Differential diagnosis; Echo-enhanced sonography