The Value of Contrast-Enhanced Ultrasound Classification in Diagnosis of Pancreatic Cystic Lesions.

Yixi Wang,Jun Shan,Kun Yan,Zhihui Fan,Yanjie Wang

doi:10.1155/2019/5698140

Abstract

Objective To compare the consistency of contrast-enhanced ultrasound (CEUS) classification results with magnetic resonance imaging (MRI) and to investigate the diagnostic value of CEUS classification in pancreatic cystic lesions. Methods 84 cases of pancreatic cystic lesions were enrolled in this study. According to the CEUS classification methods of previous study in our center, all the lesions were classified into four types: type I, unilocular cysts; type II, microcystic lesions; type III, macrocystic lesions; and type IV, cystic lesions with enhanced solid components. The consistency of CEUS and MRI typing results was analysed. Among the 84 cases, 45 cases had pathological results. The CEUS results were compared with the pathological results, and the diagnostic value of CEUS classification in diagnosing pancreatic cystic lesions was explored. Results Among the 84 cases, CEUS diagnosed 8 cases of type I, 24 of type II, 8 of type III, and 45 of type IV. MRI diagnosed 10 cases of type I, 25 of type II, 7 of type III, and 43 of type IV. The classification typing results of CEUS were highly consistent with that of enhanced MRI (kappa value: 0.852). Among the 45 cases with pathological results, the diagnostic accuracy of each type was 91.1%, 95.6%, 93.3%, and 88.9%. The accuracy of CEUS and MRI in diagnosing pancreatic cystic lesions was 75.56% (34/45) and 80% (36/45), respectively. The diagnostic accuracy of CEUS had no significant difference from that of MRI (P=0.687). Conclusion The classification results by CEUS and MRI are in excellent agreement. The classification of pancreatic cystic lesions by CEUS is significantly helpful for clinical diagnosis.

Highlights

With the development of medical imaging technology, the detection rate of pancreatic cystic lesions has gradually increased
Similar to the Bosniak classification of renal cysts [1], prestudy of our center [2] had classified pancreatic cystic lesions into 4 types based on the differences in anatomical features and contrast-enhanced ultrasound (CEUS) characteristics: type I, unilocular cysts; type II, microcystic lesions; type III, macrocystic lesions; and type IV, cystic lesions with solid components or irregular thickened cystic wall
Sahani et al [3] had proposed a similar classification based on magnetic resonance imaging (MRI), and he thought the classification could narrow the differential diagnosis of pancreatic cystic lesions. is study aimed to compare CEUS results with MRI results and investigate the diagnostic value of CEUS classification for pancreatic cystic lesions

Summary

Introduction

With the development of medical imaging technology, the detection rate of pancreatic cystic lesions has gradually increased. Because of the great difference in the treatment and prognosis of various types, preoperative identification of the type of pancreatic cystic lesions has a great guiding effect. There are no unified internationally recognized imaging classification methods for pancreatic cystic lesions. Sahani et al [3] had proposed a similar classification based on magnetic resonance imaging (MRI), and he thought the classification could narrow the differential diagnosis of pancreatic cystic lesions. Is study aimed to compare CEUS results with MRI results and investigate the diagnostic value of CEUS classification for pancreatic cystic lesions Sahani et al [3] had proposed a similar classification based on magnetic resonance imaging (MRI), and he thought the classification could narrow the differential diagnosis of pancreatic cystic lesions. is study aimed to compare CEUS results with MRI results and investigate the diagnostic value of CEUS classification for pancreatic cystic lesions

Methods

Results

Conclusion