Qualitative and Quantitative Contrast-Enhanced Ultrasonographic Assessment of Cerulein-Induced Acute Pancreatitis in Dogs

Background Acute pancreatitis (AP) is the most common disease of the canine exocrine pancreas, and accurate noninvasive diagnosis is challenging. Hypothesis/Objectives To determine the feasibility of using quantitative contrast-enhanced ultrasonography (CEUS) to detect pancreatic perfusional changes in cerulein-induced AP in dogs. Animals Six adult female Beagles. Methods Each dog received 2hours of IV infusion with 7.5 mu g/kg/h of cerulein diluted in saline. As control, all dogs received 2hours of IV infusion of saline 2weeks before cerulein infusion. CEUS of the pancreas and duodenum were performed before (0hour), and at 2, 4, 6, and 12hours after saline and cerulein infusion. Time-intensity curves were created from regions of interest in the pancreas and duodenum. Five perfusional parameters were measured for statistical analysis: time to initial up-slope, peak time, time to wash-out, peak intensity (PI), and area under the curve (AUC). Results In cerulein-induced AP, pancreatic PI increased at 2 and 4hours when compared to 0hour, and at 2, 4, and 6hours when compared to control. AUC increased at 4hours when compared to 0hour, and at 2 and 4hours when compared to control. Time to wash-out was prolonged at 4hours when compared to control. For saline control, peak time was faster at 2hours when compared to 0hour. Conclusions and Clinical Importance CEUS parameters PI and AUC can provide useful information in differentiating acute pancreatitis from normal pancreas. Cerulein-induced AP was characterized by prolonged hyperechoic enhancement on CEUS.