Skip to main content
Top
Published in: Abdominal Radiology 2/2019

01-02-2019

Double contrast-enhanced ultrasound improves the detection and localization of occult lesions in the pancreatic tail: a initial experience report

Authors: Wei Zhu, Gang Mai, Xiang Zhou, Bin Song

Published in: Abdominal Radiology | Issue 2/2019

Login to get access

Abstract

Purpose

The aim of this study is to review our initial experience of Double contrast-enhanced ultrasonography (DCEUS) in the preoperative detection of pancreatic tail occult tumors.

Methods

Thirty-five patients were recruited to undergo DCEUS of the pancreas suspected by occult lesions of pancreatic with MRI or clinical evidence. The radiologists assessed the images (conventional US, DCEUS, and MRI) for enhancement phases, tumor presence, location, enhancement characteristics, and tumor conspicuity. The differences in the onset times of the phases between DCEUS and MRI were noted. Tumor conspicuity was graded on a four-point scale for conspicuity comparison among three imaging modalities.

Results

Pancreatic tail tumors were missed on conventional transabdominal US in 11 of 35 patients. DCEUS revealed 12 lesions of 35 patients. Pancreatic tail tumors were identified on MRI in 10 of 35 patients. The sensitivity and specificity of DCEUS for depicting occult lesions of ≤ 2.2 cm were 92% and 95%, respectively. In contrast, the sensitivity and specificity of conventional US were 67% and 66%, respectively. The sensitivity and specificity of MRI were 91% and 88%, respectively. The conspicuity ratings of the three phases did not significantly differ between the DCEUS and MRI groups (P > 0.05). The DCEUS phases started much earlier than the corresponding MRI phases.

Conclusion

DCEUS is a promising technique in the detection of occult pancreatic tail tumors and is possibly superior to dynamic enhanced MRI in the case of some peripheral lesions.
Literature
1.
go back to reference Bipat S, Phoa SS, van Zeldan OM (2005) Ultrasonography, computed tomography, and magnetic resonance imaging for diagnosis and determining respectability of pancreatic adenocarcinoma: a meta-analysis. J Comput Assist Tomogr 29:438–445CrossRefPubMed Bipat S, Phoa SS, van Zeldan OM (2005) Ultrasonography, computed tomography, and magnetic resonance imaging for diagnosis and determining respectability of pancreatic adenocarcinoma: a meta-analysis. J Comput Assist Tomogr 29:438–445CrossRefPubMed
2.
go back to reference Morgan KA, Adams DB (2010) Solid tumors of the body and tail of the pancreas. Surg Clin N Am 90:287–307CrossRefPubMed Morgan KA, Adams DB (2010) Solid tumors of the body and tail of the pancreas. Surg Clin N Am 90:287–307CrossRefPubMed
3.
go back to reference D’Onofrio M, Gallotti A, Pozzi Mucelli R (2010) Imaging techniques in pancreatic tumors. Expert Rev Med Devices 7(2):257–273CrossRefPubMed D’Onofrio M, Gallotti A, Pozzi Mucelli R (2010) Imaging techniques in pancreatic tumors. Expert Rev Med Devices 7(2):257–273CrossRefPubMed
4.
go back to reference Rumack C, Wilson SR, Charboneau JW (1991) Diagnostic ultrasound. Maryland Heights: Mosby Inc, pp 145–177 Rumack C, Wilson SR, Charboneau JW (1991) Diagnostic ultrasound. Maryland Heights: Mosby Inc, pp 145–177
5.
go back to reference Shiyan L, Pintong H, Zongmin W, et al (2009) The relationship between enhanced intensity and microvessel density of gastric carcinoma using double contrast- enhanced ultrasonography. Ultrasound Med Biol 35:1086–1091CrossRefPubMed Shiyan L, Pintong H, Zongmin W, et al (2009) The relationship between enhanced intensity and microvessel density of gastric carcinoma using double contrast- enhanced ultrasonography. Ultrasound Med Biol 35:1086–1091CrossRefPubMed
6.
go back to reference Zhuang H, Yang ZG, Wang ZQ, et al (2012 Apr) Features of time-intensity curve parameters of colorectal adenocarcinomas evaluated by double-contrast enhanced ultrasonography: initial observation. Eur J Radiol 81(4):677–682CrossRefPubMed Zhuang H, Yang ZG, Wang ZQ, et al (2012 Apr) Features of time-intensity curve parameters of colorectal adenocarcinomas evaluated by double-contrast enhanced ultrasonography: initial observation. Eur J Radiol 81(4):677–682CrossRefPubMed
7.
go back to reference Sidhu PS, Cantisani V, Dietrich CF, et al (2018) The EFSUMB guidelines and recommendations for the clinical practice of contrast-enhanced ultrasound (CEUS) in non-hepatic applications: update 2017 (Long Version). Ultraschall Med. 39(2):e2–e44CrossRefPubMed Sidhu PS, Cantisani V, Dietrich CF, et al (2018) The EFSUMB guidelines and recommendations for the clinical practice of contrast-enhanced ultrasound (CEUS) in non-hepatic applications: update 2017 (Long Version). Ultraschall Med. 39(2):e2–e44CrossRefPubMed
8.
go back to reference Kalra MK, Maher MM, Mueller PR, Saini S (2003) State-of-the-art imaging of pancreatic neoplasms. Br J Radiol 76:857–865CrossRefPubMed Kalra MK, Maher MM, Mueller PR, Saini S (2003) State-of-the-art imaging of pancreatic neoplasms. Br J Radiol 76:857–865CrossRefPubMed
9.
go back to reference Sahani DV, Shah ZK, Catalano OA, Boland GW, Brugge WR (2008) Radiology of pancreatic adenocarcinoma, current status of imaging. J Gastroenterol Hepatol 23:23–33CrossRefPubMed Sahani DV, Shah ZK, Catalano OA, Boland GW, Brugge WR (2008) Radiology of pancreatic adenocarcinoma, current status of imaging. J Gastroenterol Hepatol 23:23–33CrossRefPubMed
10.
go back to reference Kartalis N, Lindholm TL, Aspelin P, Permert J, Albiin N (2009) Diffusion-weighted magnetic resonance imaging of pancreas tumours. Eur Radiol 19(8):1981–1990CrossRefPubMed Kartalis N, Lindholm TL, Aspelin P, Permert J, Albiin N (2009) Diffusion-weighted magnetic resonance imaging of pancreas tumours. Eur Radiol 19(8):1981–1990CrossRefPubMed
11.
go back to reference Cantisani V, Mortele KJ, Levy A, et al (2003) MR imaging features of solid-pseudopapillary tumor of the pancreas in adult and pediatric patients. AJR 181:395–401CrossRefPubMed Cantisani V, Mortele KJ, Levy A, et al (2003) MR imaging features of solid-pseudopapillary tumor of the pancreas in adult and pediatric patients. AJR 181:395–401CrossRefPubMed
12.
go back to reference Fletcher JG, Wiersema MJ, Farrell MA, et al (2003) Pancreatic malignancy, value of arterial, pancreatic, and hepatic phase imaging with multi-detector row CT. Radiology 229:81–90CrossRefPubMed Fletcher JG, Wiersema MJ, Farrell MA, et al (2003) Pancreatic malignancy, value of arterial, pancreatic, and hepatic phase imaging with multi-detector row CT. Radiology 229:81–90CrossRefPubMed
13.
go back to reference Kitano M, Kudo M, Maekawa K, et al (2004) Dynamic imaging of pancreatic diseases by contrast enhanced coded phase inversion harmonic ultrasonography. Gut 53:854–859CrossRefPubMedPubMedCentral Kitano M, Kudo M, Maekawa K, et al (2004) Dynamic imaging of pancreatic diseases by contrast enhanced coded phase inversion harmonic ultrasonography. Gut 53:854–859CrossRefPubMedPubMedCentral
14.
go back to reference Itoh T, Hirooka Y, Itoh A, et al (2005) Usefulness of contrast-enhanced transabdominal ultrasonography in the diagnosis of intraductal papillary mucinous tumors of the pancreas. Am J Gastroenterol 100:144–152CrossRefPubMed Itoh T, Hirooka Y, Itoh A, et al (2005) Usefulness of contrast-enhanced transabdominal ultrasonography in the diagnosis of intraductal papillary mucinous tumors of the pancreas. Am J Gastroenterol 100:144–152CrossRefPubMed
15.
go back to reference Owen NJ, Sohaib SA, Peppercorn PD, et al (2001) MRI of pancreatic neuroendocrine tumors. Br J Radiol 74:968–973CrossRefPubMed Owen NJ, Sohaib SA, Peppercorn PD, et al (2001) MRI of pancreatic neuroendocrine tumors. Br J Radiol 74:968–973CrossRefPubMed
16.
go back to reference Thoeni RF, Mueller-lisse UG, Do NK, Shyn PB (2000) Dectection of small, fuctional islet cell tumors in the pancreas: selection of MR imaging sequences for optimal sensitivity. Radiology 214:483–490CrossRefPubMed Thoeni RF, Mueller-lisse UG, Do NK, Shyn PB (2000) Dectection of small, fuctional islet cell tumors in the pancreas: selection of MR imaging sequences for optimal sensitivity. Radiology 214:483–490CrossRefPubMed
17.
go back to reference D’Onofrio M, Zamboni G, Faccioli N, Capelli P, Pozzi Mucelli R (2007) Ultrasonography of the pancreas. 4. Contrast-enhanced imaging. Abdom Imaging 32:171–181CrossRefPubMed D’Onofrio M, Zamboni G, Faccioli N, Capelli P, Pozzi Mucelli R (2007) Ultrasonography of the pancreas. 4. Contrast-enhanced imaging. Abdom Imaging 32:171–181CrossRefPubMed
18.
go back to reference Zhou Xiang, Liu Ji-Bin, Luo Yan, et al (2010) Characterization of focal liver lesions by means of assessment of hepatic transit time with contrast-enhanced US. Radiology 256:648–655CrossRefPubMed Zhou Xiang, Liu Ji-Bin, Luo Yan, et al (2010) Characterization of focal liver lesions by means of assessment of hepatic transit time with contrast-enhanced US. Radiology 256:648–655CrossRefPubMed
19.
go back to reference Zhou Xiang, Luo Yan, Peng Yu-Lan, et al (2011) Contrast-enhanced ultrasound feature of hepatic perfusion disorder related to focal liver lesions: a correlation study with contrast-enhanced CT. Radiology 260:274–281CrossRefPubMed Zhou Xiang, Luo Yan, Peng Yu-Lan, et al (2011) Contrast-enhanced ultrasound feature of hepatic perfusion disorder related to focal liver lesions: a correlation study with contrast-enhanced CT. Radiology 260:274–281CrossRefPubMed
Metadata
Title
Double contrast-enhanced ultrasound improves the detection and localization of occult lesions in the pancreatic tail: a initial experience report
Authors
Wei Zhu
Gang Mai
Xiang Zhou
Bin Song
Publication date
01-02-2019
Publisher
Springer US
Published in
Abdominal Radiology / Issue 2/2019
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-018-1746-2

Other articles of this Issue 2/2019

Abdominal Radiology 2/2019 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.