| Objective: We applied the contrast-enhanced ultrasound (CEUS) observed pancreatic lesions and pancreatic lesions of non-real features of ultrasound contrast agent infusion . Summary benign pancreatic diseases, malignant diseases, non-pancreatic lesions enhanced mode ultrasound contrast. Studies of ultrasound imaging and differential diagnosis of pancreatic lesions application value.Method: We have already established by color doppler ultrasound,enhanced CT, magnetic resonance imaging (MRI) examination detected 42 cases of pancreatic lesions in patients with the implementation of contrast-enhanced ultrasound (CEUS). We used the equipment for the PHILIPS IU22 color Doppler ultrasound device, ultrasound contrast agent was SonoVue (Sono Vue), a bottle made of contrast agent suspension with 5ml normal saline, a dose of 3.6ml, after intravenous bolus injection elbow, mechanical index of 0.06. We observed real-time, synchronous dynamic images stored in the imaging process, and with the Q-Lab software parameters on the region of interest for quantitative analysis, including the pancreatic lesion and non lesion area within the pancreatic parenchyma of contrast enhancement patterns, enhanced mode, enhanced time and enhance speed, increased levels, the pancreas various lesions characteristic of ultrasound imaging. The various test results were the final diagnosis and clinical research and the results were compared statisticallyResult: 42 cases of patients with pancreatic focal lesions, confirmed by pathology or clinical finally diagnosed 34 cases of pancreatic cancer, including ductal - 28 cases of adenocarcinoma, 1 case of pancreatic cystadenocarcinoma, pancreatic body adenocarcinoma in 1 small bag unable to type 4; pancreatic benign lesions in 8 cases, including 3 cases of benign endocrine tumors, 5 cases of focal pancreatitis.Contrast enhancement patterns: 34 cases of pancreatic cancer, 29 patients showed peripheral to the center of the grounds of the gradual increase; 2 cases around the grounds like spokes to the central enhancement; three cases of central lesions showed nodular enhancement to the surrounding. Three cases of benign pancreatic endocrine tumors were showed around more evenly to the central authorities gradually increased. Five cases of pancreatitis in three cases limits the performance of the peripheral to the central authorities gradually increased, and 2 cases showed peripheral nodular enhancement to the central authorities.Contrast-enhanced time: Started by time: from the early to late were benign, the real and malignant lesions; Between benign lesions and in real terms, in real terms between malignant lesions and benign lesions and malignant lesions were significant differences between. Start - peak time: the beginning of malignant disease - the shortest peak time, the real times, the longest of benign lesions; benign lesions and in real terms, the malignant lesions and in real terms between benign and malignant lesions were significant differences between. Peak time: benign lesions and in real terms, the malignant disease and substance between benign and malignant lesions showed no significant difference between.Contrast-enhanced mode: There are 5 types: Typeâ… : EPPP and DPPP showed low enhancement;â…¡type: EPPP and DPPP showed such enhancement;â…¢type: EPPP and DPPP was highly enhanced;â…£type: EPPP was high increase, DPPP decline for the low increase;â…¤type: EPPP were so enhanced, DPPP decline for the low increase. 34 cases of pancreatic cancer, 30 for the EPPP and the DPPP performance was uneven overall low increase, DPPP contrast agent out of time earlier than the surrounding pancreas real; two cases for the EPPP performance enhancements such as, DPPP low enhancement; the other two cases showed a high degree of EPPP inhomogeneous enhancement, DPPP low increase. 3 cases of pancreatic endocrine tumors, 2 cases showed a high degree of enhancement EPPP and DPPP uneven, one case of performance enhancements such as the EPPP and DPPP. Five cases of pancreatitis in four cases of limitations for the EPPP and DPPP uneven performance of a high degree of enhancement, one case of performance such as the EPPP and DPPP were increased.Indicators and two indicators of different combinations of different diagnostic value of pancreatic cancer: Start - peak time diagnostic accuracy of 81%, Youden index was the lowest (0.514); enhanced mode type I diagnosis of pancreatic cancer the best sensitivity and specificity, Youden index was highest (0.632), and higher diagnostic accuracy (83.3%); increase speed: the lesion was slowly increased, the sensitivity and specificity of diagnosis of pancreatic cancer with enhanced mode approach, Youden index was 0.603, diagnostic accuracy was 85.7%. Combination of different diagnostic indicators showed enhanced mode combination of type I and enhanced speed and enhanced model of the Youden index, the highest diagnostic accuracy.Conclusion:Real-time ultrasound imaging can provide more blood flow characteristics, for the diagnosis of pancreatic focal lesions and differential diagnosis of reference for diagnosis and enhanced CT is similar, there is a high clinical value. |
