American Journal of Roentgenology, Vol 169, 1263-1267, Copyright © 1997 by American Roentgen Ray Society

ARTICLES

Inflammatory pancreatic masses: differentiation from ductal carcinomas with contrast-enhanced sonography using carbon dioxide microbubbles

K Koito, T Namieno, T Nagakawa and K Morita
Department of Radiology, Sapporo Medical University, Japan.

OBJECTIVE: The aim of this study was to evaluate the clinical efficacy of contrast-enhanced sonography using carbon dioxide microbubbles to differentiate inflammatory pancreatic masses from ductal carcinomas of the pancreas. SUBJECTS AND METHODS: Fifty-five patients, including 35 patients with ductal carcinomas and 20 with inflammatory pancreatic masses, underwent contrast-enhanced sonography, CT, and digital subtraction angiography (DSA). Carbon dioxide microbubbles were prepared by mixing 10 ml of carbon dioxide and the same amount of 25% soybean oil vigorously. Carbon dioxide microbubbles were injected through an angiographic catheter that was placed in the celiac axis. Vascularity of the tumors as determined by those three techniques was interpreted by three physicians who had no knowledge of the pathologic results. RESULTS: Contrast-enhanced sonography was best at revealing tumor vascularity among the three techniques. On contrast-enhanced sonography, 19 (95%) of the 20 inflammatory pancreatic masses were isovascular and 32 (91%) of the 35 ductal carcinomas were hypovascular. In contrast, the isovascularity of inflammatory masses was five (25%) on CT, and two (10%) on DSA, respectively. The sensitivity and accuracy rate of differentiating both diseases on contrast-enhanced sonography were 98% and 95%, respectively; on CT, they were both 73%; and on DSA they were both 67%. From our results, an isovascular mass is probably an inflammatory mass, whereas a hypovascular mass is most likely a ductal carcinoma on contrast-enhanced sonography. CONCLUSION: Contrast- enhanced sonography can help differentiate an inflammatory pancreatic mass from a ductal carcinoma.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				A. Saftoiu, C. Popescu, S. Cazacu, D. Dumitrescu, C. V. Georgescu, M. Popescu, T. Ciurea, and F. Gorunescu Power Doppler endoscopic ultrasonography for the differential diagnosis between pancreatic cancer and pseudotumoral chronic pancreatitis. J. Ultrasound Med., March 1, 2006; 25(3): 363 - 372. [Abstract] [Full Text] [PDF]

				K. Takeshima, T. Kumada, H. Toyoda, S. Kiriyama, M. Tanikawa, H. Ichikawa, T. Kawachi, and S. Ogawa Comparison of IV Contrast-Enhanced Sonography and Histopathology of Pancreatic Cancer Am. J. Roentgenol., November 1, 2005; 185(5): 1193 - 1200. [Abstract] [Full Text] [PDF]

				M Kitano, M Kudo, K Maekawa, Y Suetomi, H Sakamoto, N Fukuta, R Nakaoka, and T Kawasaki Dynamic imaging of pancreatic diseases by contrast enhanced coded phase inversion harmonic ultrasonography Gut, June 1, 2004; 53(6): 854 - 859. [Abstract] [Full Text] [PDF]

				K. Numata, Y. Ozawa, N. Kobayashi, T. Kubota, N. Akinori, Y. Nakatani, K. Sugimori, T. Imada, and K. Tanaka Contrast-Enhanced Sonography of Autoimmune Pancreatitis: Comparison With Pathologic Findings J. Ultrasound Med., February 1, 2004; 23(2): 199 - 206. [Abstract] [Full Text] [PDF]

				Y. Ozawa, K. Numata, K. Tanaka, N. Ueno, T. Kiba, K. Hara, M. Morimoto, T. Sakaguchi, H. Sekihara, T. Kubota, et al. Contrast-Enhanced Sonography of Small Pancreatic Mass Lesions J. Ultrasound Med., September 1, 2002; 21(9): 983 - 991. [Abstract] [Full Text] [PDF]

				O. Oshikawa, S. Tanaka, T. Ioka, A. Nakaizumi, Y. Hamada, and T. Mitani Dynamic Sonography of Pancreatic Tumors: Comparison with Dynamic CT Am. J. Roentgenol., May 1, 2002; 178(5): 1133 - 1137. [Abstract] [Full Text] [PDF]

				K. Izuishi, K. Kato, T. Ogura, T. Kinoshita, and H. Esumi Remarkable Tolerance of Tumor Cells to Nutrient Deprivation: Possible New Biochemical Target for Cancer Therapy Cancer Res., November 1, 2000; 60(21): 6201 - 6207. [Abstract] [Full Text]

				H. Furukawa, R. Iwata, N. Moriyama, and T. Kosuge Selective Intraarterial Contrast-Enhanced CT of Pancreaticoduodenal Tumors: Early Clinical Experience in Evaluating Blood Supply and Detectability Am. J. Roentgenol., July 1, 2000; 175(1): 91 - 97. [Abstract] [Full Text] [PDF]

				S. N. Goldberg, R. C. Walovitch, J. A. Straub, M. T. Shore, and G. S. Gazelle Radio-frequency-induced Coagulation Necrosis in Rabbits: Immediate Detection at US with a Synthetic Microsphere Contrast Agent Radiology, November 1, 1999; 213(2): 438 - 444. [Abstract] [Full Text]

				L. Solbiati, S. N. Goldberg, T. Ierace, M. Dellanoce, T. Livraghi, and G. S. Gazelle Radio-frequency Ablation of Hepatic Metastases: Postprocedural Assessment with a US Microbubble Contrast Agent—Early Experience Radiology, June 1, 1999; 211(3): 643 - 649. [Abstract] [Full Text]