Department of Medical Ultrasound, Institute of Diagnostic and Interventional Ultrasound, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
J Ultrasound Med. 2019 Dec;38(12):3247-3255. doi: 10.1002/jum.15036. Epub 2019 Jun 9.
The purpose of this study was to assess the characterization and usefulness of contrast-enhanced ultrasound (CEUS) for diagnosing solid pseudopapillary tumors of the pancreas (SPTP) and compare the enhancement patterns with contrast-enhanced computed tomography (CECT).
Forty-three SPTP lesions proved by pathologic findings in 42 patients examined with CEUS and CECT were included in this study. The enhancement characteristics and typical CEUS features of the tumors were investigated. These characteristics were compared according to lesion sizes. The enhancement patterns of CEUS were compared with CECT.
The most common enhancement levels of SPTP in the early phase and late phase for CEUS were isoenhancement (19 of 43 [44.2%]) and hypoenhancement (32 of 43 [74.4%]), respectively. The 4 most common enhancement patterns were hypo-hypo (16 of 43 [37.2%]), iso-iso (11 of 43 [25.6%]), hyper-hypo (8 of 43 [18.6%]), and iso-hypo (8 of 43 [18.6%]) enhancement. For the 43 SPTP lesions, typical CEUS features such as lesion membrane, intralesional vessel, and intralesional compartmentalization enhancements were detected in 30 (69.8%), 27 (62.8%), and 10 (23.2%) cases. Compared with CECT, isoenhancement during the early phase and hypoenhancement during the late phase were the most common imaging characteristics of CEUS.
Lesion membrane, intralesional vessel, and intralesional compartmentalization enhancements are typical CEUS features of SPTP, especially for large lesions (lesion size ≥3.0 cm). Isoenhancement during the early phase and hypoenhancement during the late phase are the most common imaging characteristics of CEUS and CECT, making CEUS a viable alternative diagnostic method that is noninvasive.
本研究旨在评估超声造影（CEUS）在诊断胰腺实性假乳头状瘤（SPTP）中的特征和实用性，并与增强 CT（CECT）的增强模式进行比较。
本研究纳入了 42 例经病理证实的 43 个 SPTP 病变患者的 CEUS 和 CECT 检查结果。研究了肿瘤的增强特征和典型 CEUS 特征。根据病变大小比较了这些特征。比较了 CEUS 的增强模式与 CECT。
CEUS 早期和晚期 SPTP 的最常见增强水平分别为等增强（43 个中的 19 个[44.2%]）和低增强（43 个中的 32 个[74.4%]）。最常见的 4 种增强模式为低-低增强（43 个中的 16 个[37.2%]）、等-等增强（43 个中的 11 个[25.6%]）、高-低增强（43 个中的 8 个[18.6%]）和等-低增强（43 个中的 8 个[18.6%]）。对于 43 个 SPTP 病变，30 例（69.8%）、27 例（62.8%）和 10 例（23.2%）分别检测到病变包膜、肿瘤内血管和肿瘤内分隔增强的典型 CEUS 特征。与 CECT 相比，早期等增强和晚期低增强是 CEUS 最常见的影像学特征。
病变包膜、肿瘤内血管和肿瘤内分隔增强是 SPTP 的典型 CEUS 特征，尤其是对于较大的病变（病变大小≥3.0cm）。早期等增强和晚期低增强是 CEUS 和 CECT 最常见的影像学特征，使 CEUS 成为一种可行的替代诊断方法，具有非侵入性。
