Contrast-Enhanced Endoscopic Ultrasound for Differentially Diagnosing Autoimmune Pancreatitis and Pancreatic Cancer.
- Author:
Min Keun CHO
1
;
Sung Hoon MOON
;
Tae Jun SONG
;
Raymond E KIM
;
Dong Wook OH
;
Do Hyun PARK
;
Sang Soo LEE
;
Dong Wan SEO
;
Sung Koo LEE
;
Myung Hwan KIM
Author Information
- Publication Type:Original Article
- Keywords: Autoimmune pancreatitis; Contrast media; Endosonography; Biopsy, fine-needle; Pancreatic neoplasms
- MeSH: Biopsy, Fine-Needle; Contrast Media; Endosonography; Humans; Pancreatic Neoplasms*; Pancreatitis*; Prospective Studies; Sensitivity and Specificity; Ultrasonography*
- From:Gut and Liver 2018;12(5):591-596
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Differentially diagnosing focal-type autoimmune pancreatitis (f-AIP) and pancreatic cancer (PC) is challenging. Contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS) may provide information for differentiating pancreatic masses. In this study, we evaluated the usefulness of CEH-EUS in differentiating f-AIP from PC. METHODS: Data were collected prospectively and analyzed on patients who underwent CEH-EUS between May 2014 and May 2015. Eighty consecutive patients were diagnosed with f-AIP or PC. PC and f-AIP were compared for enhancement intensity, contrast agent distribution, and internal vasculature. RESULTS: The study group comprised 53 PC patients and 27 f-AIP patients (17 with type-1 AIP [15 definite and two probable], two with probable type-2 AIP, and eight with AIP, not otherwise specified). Hyper- to iso-enhancement in the arterial phase (f-AIP, 89% vs PC, 13%; p < 0.05), homogeneous contrast agent distribution (f-AIP, 81% vs PC, 17%; p < 0.05), and absent irregular internal vessels (f-AIP, 85% vs PC, 30%; p < 0.05) were observed more frequently in the f-AIP group. The combination of CEH-EUS and enhancement intensity, absent irregular internal vessels improved the specificity (94%) in differentiating f-AIP from PC. CONCLUSIONS: CEH-EUS may be a useful noninvasive modality for differentially diagnosing f-AIP and PC. Combined CEH-EUS findings could improve the specificity of CEH-EUS in differentiating f-AIP from PC.
