Abstract
The introduction of contrast-enhanced ultrasonography (CEUS) has led to a significant improvement in the diagnostic accuracy of ultrasound in the characterization of a pancreatic mass. CEUS, by using a blood pool contrast agent, can provide dynamic information concerning macro- and micro-circulation of focal lesions and of normal parenchyma, without the use of ionizing radiation. On the basis of personal experience and literature data, the purpose of this article is to describe and discuss CEUS imaging findings of the main solid and cystic pancreatic lesions with varying prevalence.
Highlights
Contrast-enhanced Ultrasound (CEUS) allows non-invasive assessment of normal and pathologic perfusion of various organs in real time throughout the vascular phase, without the use of ionizing radiation and with a much higher temporal resolution than Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) [? ? ? ]
CEUS examination is performed by intravenously injecting Ultrasounds contrast agents (USCAs) consisting of flexible shells presenting a radius ranging from 1 to 10 μm, containing low solubility gases [? ]
20 min after the injection, the USCAs are completely eliminated: the gas diffuses into the blood and is exhaled via the pulmonary route, while the shell components are metabolized by the liver or filtered by the kidney [? ]
Summary
Contrast-enhanced Ultrasound (CEUS) allows non-invasive assessment of normal and pathologic perfusion of various organs in real time throughout the vascular phase, without the use of ionizing radiation and with a much higher temporal resolution than Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) [? ? ? ]. ]. CEUS examination is performed by intravenously injecting Ultrasounds contrast agents (USCAs) consisting of flexible shells (e.g., phospholipids, liposomes) presenting a radius ranging from 1 to 10 μm, containing low solubility gases (e.g., perfluoro-propane, perfluorocarbon, or sulfur hexafluoride) [? ]. there is no need of laboratory tests for assessing renal function before administering USCAs. Contrast-enhanced ultrasonography (CEUS) is not recommended for the detection of a focal pancreatic mass, but it is deemed helpful in the differentiation of lesions such as adenocarcinoma, islet cell tumor, serous cystadenoma or pseudocyst, allowing a better patient clinical management [? On the basis of personal experience and literature data, CEUS characteristics of the main solid and cystic pancreatic lesions will be presented and discussed
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