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Contrast-enhanced sonography of pancreatic carcinoma: correlations with pathological findings

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Abstract

Background

We examined contrast-enhanced harmonic gray-scale sonographic findings of pancreatic carcinoma in relation to the pathological findings in resected specimens to evaluate correlations between observations made by this modality and the pathological findings.

Methods

The pathological findings of surgical specimens obtained from 16 patients were examined in relation to the contrast-enhanced harmonic gray-scale sonography findings. Lesion vascularity was examined by contrast-enhanced harmonic gray-scale sonography from 20 to 50 s after the injection of Levovist (Schering, Berlin, Germany) (early phase), and lesion enhancement was also monitored at approximately 90 s after injection (delayed phase).

Results

Contrast-enhanced harmonic gray-scale sonography showed positive enhancement in 12 of the 16 lesions (peripheral tumor region alone, n = 9; entire tumor, n = 3), while the other 4 lesions showed no contrast enhancement in any region. Twelve enhanced regions (9 peripheral tumor region and 3 entire tumor regions) detected by contrast-enhanced harmonic gray-scale sonography showed: (1) mild fibrosis with inflammation, in 10 regions (83%); (2) the presence of both carcinoma cells and residual acinar cells in 8 (67%); and (3) presence of relatively large arteries in 2 (17%). In contrast, 13 non-enhanced regions (4 entire tumor regions and 9 central regions) showed: (1) severe fibrosis in 10 regions (77%); (2) necrosis in 7 (54%); and (3) mucin in 4 (31%).

Conclusions

Contrast-enhanced harmonic gray-scale sonographic findings of pancreatic carcinoma are influenced by interstitial histological features associated with tumor growth.

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Authors and Affiliations

  1. Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan

    Kazushi Numata, Kazuya Sugimori, Kenichi Matsuo, Toshio Imada & Katsuaki Tanaka

  2. Third Department of Internal Medicine, Yokohama City University School of Medicine, Yokohama, Japan

    Yutaka Ozawa & Noritoshi Kobayashi

  3. Second Department of Surgery, Yokohama City University School of Medicine, Yokohama, Japan

    Toru Kubota & Hiroshi Shimada

  4. Department of Pathology, Yokohama City University Medical Center, Yokohama, Japan

    Akinori Nozawa & Yukio Nakatani

Authors
  1. Kazushi Numata
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  2. Yutaka Ozawa
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  3. Noritoshi Kobayashi
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  4. Toru Kubota
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  5. Hiroshi Shimada
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  6. Akinori Nozawa
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  7. Yukio Nakatani
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  8. Kazuya Sugimori
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  9. Kenichi Matsuo
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  10. Toshio Imada
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  11. Katsuaki Tanaka
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Numata, K., Ozawa, Y., Kobayashi, N. et al. Contrast-enhanced sonography of pancreatic carcinoma: correlations with pathological findings. J Gastroenterol 40, 631–640 (2005). https://doi.org/10.1007/s00535-005-1598-8

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  • DOI: https://doi.org/10.1007/s00535-005-1598-8

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