Top

Published in:

01-04-2007

Ultrasonography of the pancreas. 4. Contrast-enhanced imaging

Authors: M. D’Onofrio, G. Zamboni, N. Faccioli, P. Capelli, R. Pozzi Mucelli

Published in: Abdominal Radiology | Issue 2/2007

Abstract

The introduction of contrast-enhanced ultrasonography (CEUS) has lead to great developments in the diagnostic capabilities of ultrasound. Second generation contrast media, characterized by harmonic responses at low mechanical index of the ultrasound beam, have already proven usefulness in the study of the liver but other abdominal organs can take advantage from the dynamic study during continuous ultrasonographic scans. The dynamic observation of the enhancement allows the perfect evaluation of the abdominal organs perfusion. The perfusion of the pancreas is well correlated to the semeiology of the gland parenchymography at CEUS. The study of the pancreas is a new and promising application of CEUS. CEUS can be used to better identify pancreatic lesions respect to conventional Ultrasound (US) or to characterize pancreatic lesions already visible at US. Moreover the staging of some pancreatic lesions can be improved by the use of contrast media. This article will review the clinical application of CEUS in the different pancreatic pathologies.

D’Onofrio M, Rozzanigo U, Caffarri S, et al. (2004) Contrast-enhanced US of hepatocellular carcinoma. Radiol Med 107:293–303PubMed

Quaia E, Stacul F, Gaiani S, et al. (2004) Comparison of diagnostic performance of unenhanced vs SonoVue-enhanced ultrasonography in focal liver lesions characterization. The experience of three Italian centers. Radiol Med 108:71–81PubMed

Quaia E, Degobbis F, Tona G, et al. (2004) Differential patterns of contrast enhancement in different focal liver lesions after injection of the microbubble US contrast agent SonoVue. Radiol Med 107:155–165PubMed

D’Onofrio M, Mansueto G, Falconi M, Procacci C (2004) Neuroendocrine pancreatic tumor: value of contrast enhanced ultrasonography. Abdom Imaging 29:246–258PubMedCrossRef

Cosgrove D (2004) Advances in contrast agent imaging using Cadence contrast pulse sequencing technology (CPS) and SonoVue. Eur Rad 14(Suppl 8)

Dawson P, Cosgrove DO, Grainger RG (1999) Textbook of contrast media. Oxford, UK: Isis Medical Media

D’Onofrio M, Mansueto G, Vasori S, et al. (2003) Contrast enhanced ultrasonographic detection of small pancreatic insulinoma. J Ultrasound Med 22:413–417PubMed

Takeda K, Goto H, Hirooka Y, et al. (2003) Contrast enhanced transabdominal ultrasonography in the diagnosis of pancreatic mass lesions. Acta Radiol 44:103–106PubMedCrossRef

Lorén I, Lasson A, Fork T, et al. (1999) New sonographic imaging observations in focal pancreatitis. Eur Radiol 9:862–867PubMedCrossRef

10.

D’Onofrio M, Zamboni G, Malagò R, Martone E, Falconi M, Capelli P, Mansueto G (2005) Pancreatic pathology. In: Quaia E, ed. Contrast media in ultrasonography. Berlin: Springer-Verlag, 335–347CrossRef

11.

D’Onofrio M, Rozzanigo U, Masinielli BM, et al. (2005) Hypoechoic focal liver lesions: characterization with contrast enhanced ultrasonography. J Clin Ultrasound 33:164–172PubMedCrossRef

12.

D’Onofrio M, Martone E, Faccioli N, et al. (2006) Focal liver lesions: sinusoidal phase of CEUS. Abdom Imaging Jun 26; [Epub ahead of print]

13.

Kim T, Murakami T, Takamura M, et al. (2001) Pancreatic mass due to chronic pancreatitis: correlation of CT and MR imaging features with pathologic findings. AJR 177:367–371PubMed

14.

Koito K, Namieno T, Nagakawa T, Morita K (1997) Inflammatory pancreatic masses: differentiation from ductal carcinomas with contrast-enhanced sonography using carbon dioxide microbubbles. AJR 169:1263–1267PubMed

15.

Van Gulik TM, Reeders JW, Bosma A, et al. (1997) Incidence and clinical findings of benign, inflammatory disease in patients resected for pancreatic head cancer. Gastrointest Endosc 46:417–423PubMedCrossRef

16.

Remer EM, Baker ME (2002) Imaging of chronic pancreatitis. Radiol Clin N Am 40:1229–1242PubMed

17.

Furukawa N, Muranaka T, Yasumori K, et al. (1998) Autoimmune pancreatitis: radiologic findings in three histologically proven cases. J Comput Assist Tomogr 22:880–883PubMedCrossRef

18.

Numata K, Ozawa Y, Kobayashi N, et al. (2004) Contrast enhanced sonography of autoimmune pancreatitis. Comparison with pathologic findings. J Ultrasound Med 23:199–206PubMed

19.

Koga Y, Yamaguchi K, Sugitani A, et al. (2002) Autoimmune pancreatitis starting as a localized form. J Gastroenterol 37:133–137PubMedCrossRef

20.

Klöppel G, Schlüter E (1999) Pathology of the pancreas. In: Baert AL, Delorme G, Van Hoe L, eds. Radiology of the pancreas, 2nd ed. Berlin: Springer-Verlag, 69–100

21.

Oshikawa O, Tanaka S, Ioka T, et al. (2002) Dynamic sonography of pancreatic tumors: comparison with dynamic CT. AJR 178:1133–1137PubMed

22.

Ozawa Y, Numata K, Tanaka K, et al. (2002) Contrast-enhanced sonography of small pancreatic mass lesions. J Ultrasound Med 21:983–991PubMed

23.

D’Onofrio M, Malago R, Zamboni G, et al. (2005) Contrast-enhanced ultrasonography better identifies pancreatic tumor vascularization than helical CT. Pancreatology 5:398–402PubMedCrossRef

24.

Numata K, Ozawa Y, Kobayashi N, et al. (2005) Contrast-enhanced sonography of pancreatic carcinoma: correlations with pathological findings. J Gastroenterol 40:631–640PubMedCrossRef

25.

Procacci C, Carbognin G, Accordini S, et al. (2001) Nonfunctioning endocrine tumors of the pancreas: possibilities of spiral CT characterization. Eur Radiol 11:1175–1183PubMedCrossRef

26.

Rossi P, Allison DJ, Bezzi M, et al. (1989) Endocrine tumors of the pancreas. Radiol Clin N Am 27:129–161PubMed

27.

D’Onofrio M, Malago R, Vecchiato F, et al. (2005) Contrast-enhanced ultrasonography of small solid pseudopapillary tumors of the pancreas: enhancement pattern and pathologic correlation of 2 cases. J Ultrasound Med 24:849–854PubMed

28.

Flath B, Rickes S, Schweigert M, et al. (2003) Differentiation of pancreatic metastasis of a renal cell carcinoma from primary pancreatic carcinoma by echo-enhanced power Doppler sonography. Pancreatology 3:349–351PubMedCrossRef

29.

Megibow AJ (2003) Secondary pancreatic tumors: imaging. In: Procacci C, Megibow AJ, eds. Imaging of the pancreas. Cystic and rare tumors. Berlin: Springer-Verlag, 277–288

30.

Procacci C, Biasiutti C, Carbognin G, et al. (2001) Pancreatic neoplasms and tumor-like conditions. Eur Radiol 11(Suppl 2):S167–S192

31.

Compagno J, Oertel JE (1978) Mycrocystic adenomas of the pancreas (glycogen-rich cystoadenomas). A clinicopathologic study of 34 cases. Am J Clin Pathol 69:289–298PubMed

32.

Procacci C, Biasiutti C, Carbognin G, et al. (1999) Characterization of cystic tumors of the pancreas: CT accuracy. J Comput Assist Tomogr 23:906–912PubMedCrossRef

33.

Procacci C, Carbognin G, Biasiutti C, et al. (2001) Serous cystadenoma of the pancreas: imaging findings. Radiol Med 102:23–31PubMed

34.

Carbognin G, Tapparelli M, Petrella E, et al. (2003) Serous cystic tumors. In: Procacci C, Megibow AJ, eds. Imaging of the pancreas. Cystic and rare tumors. Berlin: Springer-Verlag, 31–37

35.

Procacci C, Graziani R, Bicego E, et al. (1997) Serous cystadenoma of the pancreas: report of 30 cases with emphasis on the imaging findings. J Comput Assist Tomogr 21:373–382PubMedCrossRef

36.

Procacci C, Graziani R, Bicego E, et al. (1996) Intraductal mucin-producing tumors of the pancreas: imaging findings. Radiology 198:249–257PubMed

37.

Hammond N, Miller FH, Sica GT, Gore RM (2002) Imaging of cystic disease of the pancreas. Radiol Clin N Am 40:1243–1262PubMedCrossRef

38.

Compagno J, Oertel JE (1978) Mucinous cystic neoplasm of the pancreas with overt and latent malignancy (cystadenocarcinoma and cystadenoma). A clinicopathologic study of 41 cases. Am J Clin Pathol 69:573–580PubMed

39.

Cohen-Scali F, Vilgrain V, Brancatelli G, et al. (2003) Discrimination of unilocular macrocystic serous cystadenoma from pancreatic pseudocyst and mucinous cystadenoma with CT: initial observations. Radiology 228:727–733PubMedCrossRef

40.

Buetow PC, Rao P, Thompson LDR (1998) Mucinous cystic neoplasm of the pancreas: radiologic-pathologic correlation. Radiographics 18:433–449PubMed

41.

Fugazzola C, Procacci C, Bergamo Andreis IA, et al. (1991) Cystic tumors of the pancreas: evaluation by ultrasonography and computer tomography. Gastrointest Radiol 16:53–61PubMedCrossRef

42.

Sperti C, Cappellazzo F, Pasquali C, et al. (1993) Cystic neoplasm of the pancreas: problems in differential diagnosis. Am Surg 59:740–745PubMed

43.

Demos TC, Posniak HV, Harmath C, et al. (2002) Cystic lesions of the pancreas. AJR 179:1375–1388PubMed

44.

Scott J, Martin I, Redhead D, et al. (2000) Mucinous cystic neoplasm of the pancreas: imaging features and diagnostic difficulties. Clin Radiol 55:187–192PubMedCrossRef

45.

Sachs JR, Deren JJ, Sohn M, Nusbaum M (1989) Mucinous cystadenoma: pitfalls of differential diagnosis. Am J Gastroenterol 84:811–816PubMed

46.

Kuba H, Yamaguchi K, Shimizu S, et al. (1998) Chronic asymptomatic pseudocyst with sludge aggregates masquerading as mucinous cystic neoplasm of the pancreas. J Gastroenterol 33:766–769PubMedCrossRef

47.

De Lima JE Jr, Javitt MC, Mathur SC (1999) Residents’ teaching files: mucinous cystic neoplasm of the pancreas. Radiographics 19:807–811PubMed

48.

Procacci C, Carbognin G, Accordini S, et al. (2001) CT features of malignant mucinous cystic tumors of the pancreas. Eur Radiol 11:1626–1630PubMedCrossRef

49.

D’Onofrio M, Caffarri S, Zamboni G, et al. (2004) Contrast-enhanced ultrasonography in the characterization of pancreatic mucinous cystadenoma. J Ultrasound Med 23:1125–1129PubMed

50.

Procacci C, Megibow AJ, Carbognin G, et al. (1999) Intraductal papillary mucinous tumor of the pancreas: a pictorial essay. Radiographics 19:1447–1463PubMed

51.

Procacci C, Carbognin G, Biasiutti C, et al. (2001) Intraductal papillary mucinous tumors of the pancreas: spectrum of CT and MR findings with pathologic correlation. Eur Radiol 11:1939–1951PubMedCrossRef

52.

Zamboni G, Capelli P, Bogina G, et al. (2003) Pathology of intraductal cystic tumors. In: Procacci C, Megibow AJ, eds. Imaging of the pancreas. Cystic and rare tumors. Berlin: Springer-Verlag, 85–94

53.

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 100:144–152PubMedCrossRef

54.

Procacci C, Schenal G, Della Chiara E, et al. (2003) Intraductal papillary mucinous tumors: imaging. In: Procacci C, Megibow AJ, eds. Imaging of the pancreas. Cystic and rare tumors. Berlin: Springer-Verlag, 97–137

55.

EFSUMB Study Group (2004) Guidelines for the use of contrast agents in ultrasound. Ultrashall Med 25:249–256CrossRef

56.

Nordback I, Saaristo R, Piironen A, Sand C (2004) Chest computed tomography in the staging of pancreatic and periampullary carcinoma. Scand J Gastroenterol 39:81–86PubMedCrossRef

57.

Nakaya H (2005) Microbubble-enhanced ultrasound exposure promotes uptake of methotrexate into synovial cells and enhanced antiinflammatory effects in the knees of rabbits with antigen-induced arthritis. Arth Rheum 52:2559–2566CrossRef

58.

Liu Y, Yang H, Sakanishi A (2005) Ultrasound: mechanical gene transfer into plant cells by sonoporation. Biotechnol Adv 24:1–16PubMedCrossRef

59.

van Wamel A, Bouakaz A, Bernard B, et al. (2005) Controlled drug delivery with ultrasound and gas microbubbles. J Control Release 101:389–391PubMed

Title: Ultrasonography of the pancreas. 4. Contrast-enhanced imaging
Authors: M. D’Onofrio
G. Zamboni
N. Faccioli
P. Capelli
R. Pozzi Mucelli
Publication date: 01-04-2007
Publisher: Springer-Verlag
Published in: Abdominal Radiology / Issue 2/2007
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-006-9010-6

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Ultrasonography of the pancreas. 4. Contrast-enhanced imaging

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2007

Ultrasonography of the pancreas. 5. Interventional procedures

Diverticulitis of the small bowel: CT diagnosis

Colitis cystica profunda: MRI appearance

Biliary atresia in infants with prolonged cholestatic jaundice: diagnostic accuracy of hepatobiliary scintigraphy

Letter to the Editor

Acute adrenal hemorrhage after blunt trauma

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page