Primary study of diagosis and differential diagnosis in periampullary carcinoma by contrast-enhanced ultrasound

Abstract

Objective To evaluate the value of contrast-enhanced ultrasound(CEUS)in diagnosis and differential diagnosis of periampullary carcinoma.Methods Twenty-two cases of periampullary carcinoma confirmed by pathology and performed CEUS.They were carcinoma of common bile duct 9 cases,carcinoma of ampulla of Vater 5 cases,carcinoma of duodenal papilla 3 cases and carcinoma of head of pancreas 5 cases.The clearly displaying rate was compared before and after CEUS.The size of lesions,enhancement parameters of beginning time,fading time,intensity and styles were observed.Results The clearly displaying rate of the lesions was improved ftom 55%(12/22)to 95%(21/22)after administering contrast media(SonoVue).There were no significant differences in enhancement beginning time,fading time and intensitv among lesions(P＞0.05).The size of lesions and enhancement styles were obviously different between carcinoma of head of pancreas and other lesions:the size of carcinoma of head of pancreas was bigger(P＜0.05).The most common enhancement style in carcinoma of head of pancreas was heterogeneous,the tumor's protruding into luminal and 'half-moon' sign were not observed;carcinoma of common bile duct,carcinoma of ampulla of Vater,carcinoma of duoderlal papilla were homogenous,the tumor's protruding into luminal and 'half-moon' sign were observed.Conclusions CEUS can significantly improve the clearly displaying rate of periampullary carcinoma,and its qualitative diagnosis;the sizes of lesions and enhancement styles have important value in differential diagnosis of periampullary carcinoma. Key words: UItrasonography; Microbubbles; Ampulla of Vater; Digestive system neoplasms; Diagnosis; differential