期刊
CLINICAL HEMORHEOLOGY AND MICROCIRCULATION
卷 81, 期 2, 页码 149-161出版社
IOS PRESS
DOI: 10.3233/CH-221390
关键词
Dynamic contrast enhanced ultrasound (DCE-US); autoimmune pancreatitis (AIP); time intensity curves (TICs); quantitative parameters; preoperative
资金
- National Natural Science Foundation of China [82071942]
- Shanghai Pujiang Program [2020PJD008]
- Clinical Research Plan of SHDC [SHDC2020CR1031B, SHDC2020CR4060]
- Shanghai Municipal Science and Technology Medical Guidance Project [18411967200]
This study explores the value of dynamic contrast-enhanced ultrasound (DCE-US) in the preoperative differential diagnosis of focal-type AIP and PDAC. The results show significant differences in enhancement patterns, time intensity curves, and quantitative parameters between AIP and PDAC lesions.
OBJECTIVE: To explore the value of dynamic contrast enhanced ultrasound (DCE-US) in preoperative differential diagnosis of focal-type autoimmune pancreatitis (AIP) and pancreatic ductal adenocarcinoma (PDAC). PATIENTS AND METHODS: From May 2016 to March 2020, patients with biopsy and histopathologically confirmed focal-type AIP (n = 9) were retrospectively included. All patients received contrast enhanced ultrasound (CEUS) examinations one week before surgery/biopsy. Dynamic analysis was performed by VueBox (R) software (Bracco, Italy). Eighteen cases of resection and histopathologically proved PDAC lesions were also included as control group. B mode ultrasound (BMUS) features, CEUS enhancement patterns, time intensity curves (TICs) and CEUS quantitative parameters were obtained and compared between AIP and PDAC lesions. RESULTS: After injection of ultrasound contrast agents, most focal-type AIP lesions displayed hyper-enhancement (2/9, 22.2%) or iso-enhancement (6/9, 66.7%) during arterial phase of CEUS, while most of PDAC lesions showed hypo-enhancement (88.9%) (P < 0.01). During late phase, most of AIP lesions showed iso-enhancement (8/9, 88.9%), while most of PDAC lesions showed hypo-enhancement (94.4%) (P < 0.001). Compared with PDAC lesions, TICs of AIP lesions showed delayed and higher enhancement. Among all CEUS perfusion parameters, ratio of PE (peak enhancement), WiAUC (wash-in area under the curve), WiR (wash-in rate), WiPI (wash-in perfusion index, WiPI = WiAUC/rise time), WoAUC (wash-out area under the curve), WiWoAUC (wash-in and wash-out area under the curve) and WoR (wash-out rate) between pancreatic lesion and surrounding normal pancreatic tissue were significantly higher in AIP lesions than PDAC lesions (P < 0.05). CONCLUSION: DCE-US with quantitative analysis has the potential to make preoperative differential diagnosis between focal-type AIP and PDAC non-invasively.
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