Application of qualitative and quantitative analysis of contrast-enhanced ultrasound in the differential diagnosis of pancreatic ductal adenocarcinoma and non-pancreatic ductal adenocarcinoma
10.3760/cma.j.cn131148-20240407-00214
- VernacularTitle:超声造影定性及定量分析在胰腺导管腺癌与非导管腺癌鉴别诊断中的应用价值
- Author:
Lihui ZHAO
1
;
Wenjing HOU
;
Jing ZHAO
;
Jie MU
;
Yiran MAO
;
Hailing WANG
;
Song GAO
;
Jian WANG
;
Tiansuo ZHAO
;
Xi WEI
Author Information
1. 天津医科大学肿瘤医院超声诊疗科 国家恶性肿瘤临床医学研究中心 天津市肿瘤防治重点实验室 天津市恶性肿瘤临床医学研究中心 天津市消化系统肿瘤重点实验室，天津 300060
- Keywords:
Contrast-enhanced ultrasound;
Pancreas;
Focal lesion;
Quantitative analysis;
Ductal adenocarcinoma
- From:
Chinese Journal of Ultrasonography
2024;33(10):855-861
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application value of qualitative characteristics and quantitative parameters of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of pancreatic ductal adenocarcinoma (PDAC) and non-PDAC presenting as pancreatic solid focal lesions.Methods:A retrospective analysis was conducted on 64 cases of PDAC(the PDAC group) and 52 cases of non-PDAC(the non-PDAC group) who underwent CEUS examination at Tianjin Medical University Cancer Institute and Hospital from July 2022 to June 2023. Clinical characteristics, two-dimensional ultrasound features, CEUS qualitative characteristic, and quantitative parameters were compared between the two groups. ROC curves were plotted, and the Delong test was used to evaluate the diagnostic performance of qualitative and quantitative analyses in distinguishing PDAC from non-PDAC. Binary logistic regression analysis was employed to assess the independent predictors of PDAC.Results:①There were significant differences in serum CA19-9, lesion size, boundary, the main pancreatic duct (MPD) diameter, degree of enhancement and enhancement pattern between the PDAC group and the non-PDAC group (all P<0.05). ②The relative peak intensity (rPE), and relative wash-in and wash-out area under the curve (rWiWoAUC) were lower in the PDAC group than the non-PDAC group, with statistically significant differences(all P<0.001). ③The areas under the curve (AUC) for diagnosing PDAC using enhancement pattern, venous phase(VP) enhancement degree, rPE, and rWiWoAUC were 0.698, 0.707, 0.863, and 0.867, respectively. The AUCs of quantitative parameters were superior to those of qualitative characteristics, with statistically significant differences ( P<0.05). Using CEUS mode B, low VP enhancement, rPE<72.44, and rWiWoAUC<86.59 as cut-off values, the accuracies for diagnosing PDAC were 0.698, 0.741, 0.828, and 0.802, respectively. ④Serum CA19-9, lesion size, MPD diameter, rPE, and rWiWoAUC were independent predictors of PDAC (all P<0.05). Conclusions:CEUS qualitative and quantitative analyses are helpful in the differential diagnosis of PDAC and non-PDAC, with rPE and rWiWoAUC being useful indicators for diagnosing PDAC.
