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

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

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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.

Original languageEnglish
Pages (from-to)1073-1079
Number of pages7
JournalPancreas
Volume40
Issue number7
DOIs
Publication statusPublished - 10-2011

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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    Matsubara, H., Itoh, A., Kawashima, H., Kasugai, T., Ohno, E., Ishikawa, T., Itoh, Y., Nakamura, Y., Hiramatsu, T., Nakamura, M., Miyahara, R., Ohmiya, N., Ishigami, M., Katano, Y., Goto, H., & Hirooka, Y. (2011). Dynamic quantitative evaluation of contrast-enhanced endoscopic ultrasonography in the diagnosis of pancreatic diseases. Pancreas, 40(7), 1073-1079. https://doi.org/10.1097/MPA.0b013e31821f57b7