AIM： To describe and discuss echo-enhanced sonography in the differential diagnosis of cystic pancreatic lesions. METHODS： The pulse inversion technique （with intravenous injection of 2.4 mL SonoVue） or the power-...AIM： To describe and discuss echo-enhanced sonography in the differential diagnosis of cystic pancreatic lesions. METHODS： The pulse inversion technique （with intravenous injection of 2.4 mL SonoVue） or the power-Doppler mode under the conditions of the 2^nd harmonic imaging （with intravenous injection of 4 g Levovist） was used for echo-enhanced sonography. RESULTS： Cystadenomas frequently showed many vessels along fibrotic strands. On the other hand, cystadenocarcinomas were poorly and chaotically vascularized. ＂Young pseudocysts＂ were frequently found to have a highly vascularised wall. However, the wall of the ＂old pseudocysts＂ was poorly vascularized. Data from prospective studies demonstrated that based on these imaging criteria the sensitivities and specificities of echoenhanced sonography in the differentiation of cystic pancreatic masses were 〉 90%. CONCLUSION： Cystic pancreatic masses have a different vascularization pattern at echo-enhanced sonography. These characteristics are useful for their differential diagnosis, but histology is still the gold standard.展开更多
A 54-year-old woman was admitted to our hospital with the complaint of right upper quadrant pain. Upon physical examination the vital signs of the patient were within normal ranges. Ultrasonography and computed tomogr...A 54-year-old woman was admitted to our hospital with the complaint of right upper quadrant pain. Upon physical examination the vital signs of the patient were within normal ranges. Ultrasonography and computed tomography （CT） examination of the abdomen was obtained, which demonstrated a large dilatated cystic structure, measuring approximately 68.6 mm × 48.6 mm, with marked distension and inflammation. Additionally, the enhanced CT was characterized by the non-enhanced wall of the gallbladder. As the third examination in this study, magnetic resonance imaging （MRI）, namely coronal MRI and magnetic resonance cholangio-pancreatography （MRCP）, were performed. The MRCP demonstrated a dilatation of the gallbladder but detected no neck of the gallbladder. Simple cholecystectomy was performed. Macroscopic findings included a distended and gangrenous gallbladder, and closer examination revealed a counterclockwise torsion of 360 degrees on the gallbladder mesentery. Coronal MRI and MRCP showing characteristic radiography may be useful in making a definitive diagnosis.展开更多
文摘AIM： To describe and discuss echo-enhanced sonography in the differential diagnosis of cystic pancreatic lesions. METHODS： The pulse inversion technique （with intravenous injection of 2.4 mL SonoVue） or the power-Doppler mode under the conditions of the 2^nd harmonic imaging （with intravenous injection of 4 g Levovist） was used for echo-enhanced sonography. RESULTS： Cystadenomas frequently showed many vessels along fibrotic strands. On the other hand, cystadenocarcinomas were poorly and chaotically vascularized. ＂Young pseudocysts＂ were frequently found to have a highly vascularised wall. However, the wall of the ＂old pseudocysts＂ was poorly vascularized. Data from prospective studies demonstrated that based on these imaging criteria the sensitivities and specificities of echoenhanced sonography in the differentiation of cystic pancreatic masses were 〉 90%. CONCLUSION： Cystic pancreatic masses have a different vascularization pattern at echo-enhanced sonography. These characteristics are useful for their differential diagnosis, but histology is still the gold standard.
文摘A 54-year-old woman was admitted to our hospital with the complaint of right upper quadrant pain. Upon physical examination the vital signs of the patient were within normal ranges. Ultrasonography and computed tomography （CT） examination of the abdomen was obtained, which demonstrated a large dilatated cystic structure, measuring approximately 68.6 mm × 48.6 mm, with marked distension and inflammation. Additionally, the enhanced CT was characterized by the non-enhanced wall of the gallbladder. As the third examination in this study, magnetic resonance imaging （MRI）, namely coronal MRI and magnetic resonance cholangio-pancreatography （MRCP）, were performed. The MRCP demonstrated a dilatation of the gallbladder but detected no neck of the gallbladder. Simple cholecystectomy was performed. Macroscopic findings included a distended and gangrenous gallbladder, and closer examination revealed a counterclockwise torsion of 360 degrees on the gallbladder mesentery. Coronal MRI and MRCP showing characteristic radiography may be useful in making a definitive diagnosis.
