Ultrasonographic and endoscopic ultrasonographic angiography in pancreatic mass lesions

Extracorporeal ultrasonographic (US) angiography and endoscopic ultrasonographic (EUS) angiography were performed in 40 lesions on 39 patients with various pancreatic diseases to evaluate characteristic findings. Pancreatic cancer (duct cell carcinoma) showed negative or slight enhancement. Islet cell tumor, serous cystadenoma composed of microcysts, and intraductal papillary adenoma showed strong enhancement. Solid and papillary tumor showed enhancement in the central lesion. Four of 6 cases with pseudotumorous pancreatitis had iso-enhancement which disappeared earlier than that in the pancreatic parenchyma. However, 2 cases showed slight or negative enhancement similar to pancreatic duct cell carcinoma. US angiography is useful in evaluating the vascularity of various pancreatic lesions, especially small lesions, in dynamic real-time images. EUS angiography is also useful in evaluating the vascularity in lesions that cannot be detected by US.