The development of CEUS has contributed to improve the diagnosis of pancreatic lesions. However, only few controlled studies are available. We aimed to prospectively evaluate the role of CEUS in characterization of pancreatic lesions.58 patients (38 male, median age 73 yrs) with 63 histologically proven pancreatic lesions detectable at the US were investigated. The final diagnosis were: 18 adenocarcinoma, 5 insulinomas, 8 mass forming pancreatitis (MFP), 6 intraductal papillary mucinous tumors [IPMT], 13 pseudocystis, 8 serous cystadenoma [SCA] and 5 mucinous cystadenoma [MCA]. After standard US, 2-4 mL of Sonovue i.v. was administered. The CEUS findings were compared with those obtained by computed tomography (CT) or magnetic resonance (MRI). The histological diagnosis in all cases was obtained either from biopsy or surgical specimens.
Results: Based on CEUS findings, solid lesions showing hypovascular pattern were diagnosed as carcinomas, those with hypervascular pattern as neuroendocrin tumors, and the hysovascular ones as MFP. All lesions fit these US criteria according to final diagnosis.CT or MRI findings in all cases were also confirmed at the final diagnosis. Concerning the cystic lesions, all except one were non vascular, even when a corpuscular content was found at basal US (sensitivity 90%). In all cases of SCA and MCA with intralesional septis, CEUS demonstrated a vascular enhancement. In contrast, in the absence of intralesional features within cystic lesions differential diagnosis could not be achieved (sensitivity 65%).
Conclusions: Our data, although preliminary, demonstrate that the study of the pancreas is a new and promising application of CEUS.