Contrast-enhanced sonography of pancreatic carcinoma: correlations with pathological findings.

Abstract

BACKGROUND:

We examined contrast-enhanced harmonic gray-scale sonographic findings of pancreatic carcinoma in relation to the pathological findings in resected specimens to evaluate correlations between observations made by this modality and the pathological findings.

METHODS:

The pathological findings of surgical specimens obtained from 16 patients were examined in relation to the contrast-enhanced harmonic gray-scale sonography findings. Lesion vascularity was examined by contrast-enhanced harmonic gray-scale sonography from 20 to 50 s after the injection of Levovist (Schering, Berlin, Germany) (early phase), and lesion enhancement was also monitored at approximately 90 s after injection (delayed phase).

RESULTS:

Contrast-enhanced harmonic gray-scale sonography showed positive enhancement in 12 of the 16 lesions (peripheral tumor region alone, n = 9; entire tumor, n = 3), while the other 4 lesions showed no contrast enhancement in any region. Twelve enhanced regions (9 peripheral tumor region and 3 entire tumor regions) detected by contrast-enhanced harmonic gray-scale sonography showed: (1) mild fibrosis with inflammation, in 10 regions (83%); (2) the presence of both carcinoma cells and residual acinar cells in 8 (67%); and (3) presence of relatively large arteries in 2 (17%). In contrast, 13 non-enhanced regions (4 entire tumor regions and 9 central regions) showed: (1) severe fibrosis in 10 regions (77%); (2) necrosis in 7 (54%); and (3) mucin in 4 (31%).

CONCLUSIONS:

Contrast-enhanced harmonic gray-scale sonographic findings of pancreatic carcinoma are influenced by interstitial histological features associated with tumor growth.

• Authors: Kazushi Numata, Yutaka Ozawa, Noritoshi Kobayashi, Toru Kubota, Hiroshi Shimada, Akinori Nozawa, Yukio Nakatani, Kazuya Sugimori, Kenichi Matsuo, Toshio Imada, Katsuaki Tanaka
• Journal: Journal of gastroenterology (J Gastroenterol) Vol. 40 Issue 6 Pg. 631-40 (Jun 2005) ISSN: 0944-1174 [Print] Japan
• PMID: 16007398 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Contrast Media
• Polysaccharides
• SHU 508

Topics

• Aged
• Carcinoma (diagnostic imaging, pathology)
• Contrast Media (administration & dosage)
• Female
• Follow-Up Studies
• Humans
• Injections, Intravenous
• Male
• Middle Aged
• Pancreatic Neoplasms (diagnostic imaging, pathology)
• Polysaccharides (administration & dosage)
• Retrospective Studies
• Sensitivity and Specificity
• Severity of Illness Index
• Tomography, X-Ray Computed
• Ultrasonography