Quantitative analysis of pancreatic disorders using contrast-enhanced endoscopic ultrasonography

Abstract

The usefulness of endoscopic ultrasonography(EUS) for diagnosing pancreatic disorders is widely recognized; on the other hand, the characteristic vascularity of each disorder is well known. Further improvement of the diagnostic accuracy using second-generation ultrasound contrast agents has recently been experienced. We investigated the usefulness of contrast-enhanced EUS(CE-EUS) for the differential diagnosis of pancreatic disorders. Patients with pancreatic ductal cancer(PC), autoimmune pancreatitis(AIP), mass-forming pancreatitis(MFP), and pancreatic endocrine tumor(PET) who underwent CE-EUS at our institute were analyzed retrospectively. The contrast agent, Sonazoid^® (Daiichi Sankyo, Tokyo, Japan), was injected intravenously. Time-intensity curve (TIC)-based quantitative evaluation of the pancreatic disorders and performance of EUS in combination with TIC was performed to diagnose benignancy or malignancy. The echo-intensity reduction rate at 1 minute was significantly greater in PC than AIP, MFP and PET. The CE-EUS with the dynamic quantitative analysis of TIC increased the diagnostic accuracy for pancreatic disorders.