Skip to main content
SpringerLink
Log in

Role of transabdominal ultrasonography in the diagnosis of pancreatic cystic lesions

  • Special Feature: Review Article
  • Ultrasonographic diagnosis of pancreatic diseases-This is all you need
  • Published:
Journal of Medical Ultrasonics Aims and scope Submit manuscript

Abstract

Pancreatic cystic lesions (PCLs) are incidental findings that are being increasingly identified because of recent advancements in abdominal imaging technologies. PCLs include different entities, with each of them having a peculiar biological behavior, and they range from benign to premalignant or malignant neoplasms. Therefore, accurate diagnosis is important to determine the best treatment strategy. As transabdominal ultrasonography (US) is noninvasive, inexpensive, and widely available, it is considered to be the most appropriate imaging modality for the initial evaluation of abdominal diseases, including PCLs, and for follow-up assessment. We present a review of the possibilities and limits of US in the diagnosis of PCLs, the technical development of US, and the ultrasonographic characteristics of PCLs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Zerboni G, Signoretti M, Crippa S, et al. Systematic review and meta-analysis: prevalence of incidentally detected pancreatic cystic lesions in asymptomatic individuals. Pancreatology. 2019;19:2–9.

    PubMed  Google Scholar 

  2. Laffan TA, Horton KM, Klein AP, et al. Prevalence of unsuspected pancreatic cysts on MDCT. AJR Am J Roentgenol. 2008;191:802–7.

    PubMed  PubMed Central  Google Scholar 

  3. Ip IK, Mortele KJ, Prevedello LM, et al. Focal cystic pancreatic lesions: assessing variation in radiologists’ management recommendations. Radiology. 2011;259:136–41.

    PubMed  Google Scholar 

  4. Zanini N, Giordano M, Smerieri E, et al. Estimation of the prevalence of asymptomatic pancreatic cysts in the population of San Marino. Pancreatology. 2015;15:417–22.

    PubMed  Google Scholar 

  5. Ippolito D, Allegranza P, Bonaffini PA, et al. Diagnostic accuracy of 256-detector row computed tomography in detection and characterization of incidental pancreatic cystic lesions. Gastroenterol Res Pract. 2015;2015:707546.

    PubMed  PubMed Central  CAS  Google Scholar 

  6. Chang YR, Park JK, Jang JY, et al. Incidental pancreatic cystic neoplasms in an asymptomatic healthy population of 21,745 individuals: large-scale, single-center cohort study. Medicine (Baltimore). 2016;95:e5535.

    Google Scholar 

  7. Ikeda M, Sato T, Morozumi A, et al. Morphologic changes in the pancreas detected by screening ultrasonography in a mass survey, with special reference to main duct dilatation, cyst formation, and calcification. Pancreas. 1994;9:508–12.

    PubMed  CAS  Google Scholar 

  8. Soroida Y, Sato M, Hikita H, et al. Pancreatic cysts in general population on ultrasonography: prevalence and development of risk score. J Gastroenterol. 2016;51:1133–40.

    PubMed  Google Scholar 

  9. Moris M, Bridges MD, Pooley RA, et al. Association between advances in high-resolution cross-section imaging technologies and increase in prevalence of pancreatic cysts from 2005 to 2014. Clin Gastroenterol Hepatol. 2016;14:e3.

    Google Scholar 

  10. Girometti R, Intini S, Brondani G, et al. Incidental pancreatic cysts on 3D turbo spin echo magnetic resonance cholangiopancreatography: prevalence and relation with clinical and imaging features. Abdom Imaging. 2011;36:196–205.

    PubMed  Google Scholar 

  11. Zhang XM, Mitchell DG, Dohke M, et al. Pancreatic cysts: depiction on single-shot fast spin-echo MR images. Radiology. 2002;223:547–53.

    PubMed  Google Scholar 

  12. Lee KS, Sekhar A, Rofsky NM, et al. Prevalence of incidental pancreatic cysts in the adult population on MR imaging. Am J Gastroenterol. 2010;105:2079–84.

    PubMed  Google Scholar 

  13. Matsubara S, Tada M, Akahane M, et al. Incidental pancreatic cysts found by magnetic resonance imaging and their relationship with pancreatic cancer. Pancreas. 2012;41:1241–6.

    PubMed  Google Scholar 

  14. Kromrey ML, Bülow R, Hübner J, et al. Prospective study on the incidence, prevalence and 5-year pancreatic-related mortality of pancreatic cysts in a population-based study. Gut. 2018;67:138–45.

    PubMed  Google Scholar 

  15. Sey MS, Teagarden S, Settles D, et al. Prospective cross-sectional study of the prevalence of incidental pancreatic cysts during routine outpatient endoscopic ultrasound. Pancreas. 2015;44:1130–3.

    PubMed  Google Scholar 

  16. Martínez B, Martínez JF, Aparicio JR. Aparicio, prevalence of incidental pancreatic cyst on upper endoscopic ultrasound. Ann Gastroenterol. 2018;31:90–5.

    PubMed  Google Scholar 

  17. Fernández-del Castillo C, Targarona J, Thayer SP, et al. Incidental pancreatic cysts: clinicopathologic characteristics and comparison with symptomatic patients. Arch Surg. 2003;138:427–34 [discussion 433–434].

    PubMed  PubMed Central  Google Scholar 

  18. Brugge WR, Lauwers GY, Sahani D, et al. Cystic neoplasms of the pancreas. N Engl J Med. 2004;351:1218–26.

    PubMed  CAS  Google Scholar 

  19. Johnson CD, Stephens DH, Charboneau JW, et al. Cystic pancreatic tumors: CT and sonographic assessment. AJR Am J Roentgenol. 1988;151:1133–8.

    PubMed  CAS  Google Scholar 

  20. Yamaguchi K, Enjoji M. Cystic neoplasms of the pancreas. Gastroenterology. 1987;92:1934–43.

    PubMed  CAS  Google Scholar 

  21. Tanaka M, Chari S, Adsay V, et al. International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas. Pancreatology. 2006;6:17–32.

    PubMed  Google Scholar 

  22. Tanaka M, Fernández-Del Castillo C, Kamisawa T, et al. Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology. 2017;17:738–53.

    PubMed  Google Scholar 

  23. Tada M, Kawabe T, Arizumi M, et al. Pancreatic cancer in patients with pancreatic cystic lesions: a prospective study in 197 patients. Clin Gastroenterol Hepatol. 2006;4:1265–70.

    PubMed  Google Scholar 

  24. Tanaka S, Nakao M, Ioka T, et al. Slight dilatation of the main pancreatic duct and presence of pancreatic cysts as predictive signs of pancreatic cancer: a prospective study. Radiology. 2010;254:965–72.

    PubMed  Google Scholar 

  25. Chernyak V, Flusberg M, Haramati LB, et al. Incidental pancreatic cystic lesions: is there a relationship with the development of pancreatic adenocarcinoma and all-cause mortality? Radiology. 2015;274:161–9.

    PubMed  Google Scholar 

  26. Ohno E, Hirooka Y, Kawashima H, et al. Natural history of pancreatic cystic lesions: a multicenter prospective observational study for evaluating the risk of pancreatic cancer. J Gastroenterol Hepatol. 2018;33:320–8.

    PubMed  Google Scholar 

  27. Nakao M, Katayama K, Fukuda J, et al. Evaluating the ability to detect pancreatic lesions using a special ultrasonography examination focusing on the pancreas. Eur J Radiol. 2017;91:10–4.

    PubMed  Google Scholar 

  28. Jeon JH, Kim JH, Joo I, et al. Transabdominal ultrasound detection of pancreatic cysts incidentally detected at CT, MRI, or endoscopic ultrasound. AJR Am J Roentgenol. 2018;210:518–25.

    PubMed  Google Scholar 

  29. Sun MRM, Strickland CD, Tamjeedi B, et al. Utility of transabdominal ultrasound for surveillance of known pancreatic cystic lesions: prospective evaluation with MRI as reference standard. Abdom Radiol (NY). 2018;43:1180–92.

    Google Scholar 

  30. Sumi H, Itoh A, Kawashima H, et al. Preliminary study on evaluation of the pancreatic tail observable limit of transabdominal ultrasonography using a position sensor and CT-fusion image. Eur J Radiol. 2014;83:1324–31.

    PubMed  Google Scholar 

  31. Gandolfi L, Torresan F, Solmi L, et al. The role of ultrasound in biliary and pancreatic diseases. Eur J Ultrasound. 2003;16:141–59.

    PubMed  Google Scholar 

  32. Bertolotto M, D’Onofrio M, Martone E, et al. Ultrasonography of the pancreas. 3. Doppler imaging. Abdom Imaging. 2007;32:161–70.

    PubMed  CAS  Google Scholar 

  33. Yamanaka Y, Ishida H, Naganuma H, et al. Superb microvascular imaging (SMI) findings of splenic artery pseudoaneurysm: a report of two cases. J Med Ultrason. 2001;2018:515–23.

    Google Scholar 

  34. Tokodai K, Miyagi S, Nakanishi C, et al. The utility of superb microvascular imaging for monitoring low-velocity venous flow following pancreas transplantation: report of a case. J Med Ultrason. 2001;2018:171–4.

    Google Scholar 

  35. Hohl C, Schmidt T, Honnef D, et al. Ultrasonography of the pancreas. 2. Harmonic imaging. Abdom Imaging. 2007;32:150–60.

    PubMed  CAS  Google Scholar 

  36. Shapiro RS, Wagreich J, Parsons RB, et al. Tissue harmonic imaging sonography: evaluation of image quality compared with conventional sonography. AJR Am J Roentgenol. 1998;171:1203–6.

    PubMed  CAS  Google Scholar 

  37. Choudhry S, Gorman B, Charboneau JW, et al. Comparison of tissue harmonic imaging with conventional US in abdominal disease. Radiographics. 2000;20:1127–35.

    PubMed  CAS  Google Scholar 

  38. Littmann M, Schwaiger U, Sczepanski B, et al. Improved ultrasound imaging of the pancreas with the transsplenic view and tissue harmonic imaging. Ultraschall Med. 2001;22:163–6.

    PubMed  CAS  Google Scholar 

  39. Hohl C, Schmidt T, Haage P, et al. Phase-inversion tissue harmonic imaging compared with conventional B-mode ultrasound in the evaluation of pancreatic lesions. Eur Radiol. 2004;14:1109–17.

    PubMed  Google Scholar 

  40. Sidhu PS, Cantisani V, Dietrich CF, et al. The EFSUMB guidelines and recommendations for the clinical practice of contrast-enhanced ultrasound (CEUS) in non-hepatic applications: update 2017 (short version). Ultraschall Med. 2018;39:154–80.

    PubMed  Google Scholar 

  41. Takeda K, Goto H, Hirooka Y, et al. Contrast-enhanced transabdominal ultrasonography in the diagnosis of pancreatic mass lesions. Acta Radiol. 2003;44:103–6.

    PubMed  CAS  Google Scholar 

  42. Kitano M, Kudo M, Maekawa K, et al. Dynamic imaging of pancreatic diseases by contrast enhanced coded phase inversion harmonic ultrasonography. Gut. 2004;53:854–9.

    PubMed  PubMed Central  CAS  Google Scholar 

  43. Rickes S, Malfertheiner P. Echo-enhanced sonography–an increasingly used procedure for the differentiation of pancreatic tumors. Dig Dis. 2004;22:32–8.

    PubMed  Google Scholar 

  44. Beyer-Enke SA, Hocke M, Ignee A, et al. Contrast enhanced transabdominal ultrasound in the characterisation of pancreatic lesions with cystic appearance. JOP. 2010;11:427–33.

    PubMed  Google Scholar 

  45. Rickes S, Mönkemüller K, Malfertheiner P. Echo-enhanced ultrasound with pulse inversion imaging: a new imaging modality for the differentiation of cystic pancreatic tumours. World J Gastroenterol. 2006;12:2205–8.

    PubMed  PubMed Central  Google Scholar 

  46. D’Onofrio M, Barbi E, Dietrich CF, et al. Pancreatic multicenter ultrasound study (PAMUS). Eur J Radiol. 2012;81:630–8.

    PubMed  Google Scholar 

  47. Vasile TA, Socaciu M, Stan Iuga R, et al. Added value of intravenous contrast-enhanced ultrasound for characterization of cystic pancreatic masses: a prospective study on 37 patients. Med Ultrason. 2012;14:108–14.

    PubMed  Google Scholar 

  48. Fukuda J, Tanaka S, Ishida N, et al. A case of stage IA pancreatic ductal adenocarcinoma accompanied with focal pancreatitis demonstrated by contrast-enhanced ultrasonography. J Med Ultrason. 2001;2018:617–22.

    Google Scholar 

  49. D’Onofrio M, Megibow AJ, Faccioli N, et al. Comparison of contrast-enhanced sonography and MRI in displaying anatomic features of cystic pancreatic masses. AJR Am J Roentgenol. 2007;189:1435–42.

    PubMed  Google Scholar 

  50. Fan Z, Yan K, Wang Y, et al. Application of contrast-enhanced ultrasound in cystic pancreatic lesions using a simplified classification diagnostic criterion. Biomed Res Int. 2015;2015:974621.

    PubMed  PubMed Central  Google Scholar 

  51. Lü K, Dai Q, Xu ZH, et al. Ultrasonographic characteristics of intraductal papillary mucinous neoplasm of the pancreas. Chin Med Sci J. 2010;25:151–5.

    PubMed  Google Scholar 

  52. Hammond N, Miller FH, Sica GT, et al. Imaging of cystic diseases of the pancreas. Radiol Clin North Am. 2002;40:1243–62.

    PubMed  Google Scholar 

  53. D’Onofrio M, Caffarri S, Zamboni G, et al. Contrast-enhanced ultrasonography in the characterization of pancreatic mucinous cystadenoma. J Ultrasound Med. 2004;23:1125–9.

    PubMed  Google Scholar 

  54. Itoh T, Hirooka Y, Itoh A, et al. Usefulness of contrast-enhanced transabdominal ultrasonography in the diagnosis of intraductal papillary mucinous tumors of the pancreas. Am J Gastroenterol. 2005;100:144–52.

    PubMed  Google Scholar 

  55. Loftus EV Jr, Olivares-Pakzad BA, Batts KP, et al. Intraductal papillary-mucinous tumors of the pancreas: clinicopathologic features, outcome, and nomenclature. Members of the pancreas clinic, and pancreatic surgeons of mayo clinic. Gastroenterology. 1996;110:1909–18.

    PubMed  Google Scholar 

  56. Kakizaki Y, Makino N, Tozawa T, et al. Stromal fibrosis and expression of matricellular proteins correlate with histological grade of intraductal papillary mucinous neoplasm of the pancreas. Pancreas. 2016;45:1145–52.

    PubMed  PubMed Central  CAS  Google Scholar 

  57. Shiina T. JSUM ultrasound elastography practice guidelines: basics and terminology. J Med Ultrason. 2001;2013:309–23.

    Google Scholar 

  58. Hirooka Y, Kuwahara T, Irisawa A, et al. JSUM ultrasound elastography practice guidelines: pancreas. J Med Ultrason. 2001;2015:151–74.

    Google Scholar 

  59. Ohno E, Hirooka Y, Kawashima H, et al. Feasibility and usefulness of endoscopic ultrasonography-guided shear-wave measurement for assessment of autoimmune pancreatitis activity: a prospective exploratory study. J Med Ultrason. 2019. https://doi.org/10.1007/s10396-019-00944-4.

    Article  Google Scholar 

  60. Koya T, Kawashima H, Ohno E, et al. Increased hardness of the underlying pancreas correlates with the presence of intraductal papillary-mucinous neoplasm in a limited number of cases. J Med Ultrason. 2019. https://doi.org/10.1007/s10396-019-00956-0.

    Article  Google Scholar 

  61. Maguchi H, Tanno S, Mizuno N, et al. Natural history of branch duct intraductal papillary mucinous neoplasms of the pancreas: a multicenter study in Japan. Pancreas. 2011;40:364–70.

    PubMed  Google Scholar 

  62. Yamaguchi T, Baba T, Ishihara T, et al. Long-term follow-up of intraductal papillary mucinous neoplasm of the pancreas with ultrasonography. Clin Gastroenterol Hepatol. 2005;3:1136–43.

    PubMed  Google Scholar 

  63. Uehara H, Nakaizumi A, Ishikawa O, et al. Development of ductal carcinoma of the pancreas during follow-up of branch duct intraductal papillary mucinous neoplasm of the pancreas. Gut. 2008;57:1561–5.

    PubMed  CAS  Google Scholar 

  64. Tanno S, Nakano Y, Koizumi K, et al. Pancreatic ductal adenocarcinomas in long-term follow-up patients with branch duct intraductal papillary mucinous neoplasms. Pancreas. 2010;39:36–40.

    PubMed  Google Scholar 

  65. Mandai K, Uno K, Nakase K, et al. Association between hyperechogenic pancreas and pancreatic ductal adenocarcinoma concomitant with intraductal papillary mucinous neoplasms. J Med Ultrason. 2019. https://doi.org/10.1007/s10396-019-00949-z.

    Article  Google Scholar 

  66. Kamata K, Kitano M, Kudo M, et al. Value of EUS in early detection of pancreatic ductal adenocarcinomas in patients with intraductal papillary mucinous neoplasms. Endoscopy. 2014;46:22–9.

    PubMed  Google Scholar 

  67. Torisu Y, Takakura K, Kinoshita Y, et al. Pancreatic cancer screening in patients with presumed branch-duct intraductal papillary mucinous neoplasms. World J Clin Oncol. 2019;10:67–74.

    PubMed  PubMed Central  Google Scholar 

  68. Vege SS, Ziring B, Jain R, et al. American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology. 2015;148:819–22 [quize 12–13].

    PubMed  Google Scholar 

  69. Compton CC. Serous cystic tumors of the pancreas. Semin Diagn Pathol. 2000;17:43–55.

    PubMed  CAS  Google Scholar 

  70. Compagno J, Oertel JE. Microcystic adenomas of the pancreas (glycogen-rich cystadenomas): a clinicopathologic study of 34 cases. Am J Clin Pathol. 1978;69:289–98.

    PubMed  CAS  Google Scholar 

  71. Torresan F, Casadei R, Solmi L, et al. The role of ultrasound in the differential diagnosis of serous and mucinous cystic tumours of the pancreas. Eur J Gastroenterol Hepatol. 1997;9:169–72.

    PubMed  CAS  Google Scholar 

  72. Lewin M, Hoeffel C, Azizi L, et al. Imaging of incidental cystic lesions of the pancreas. J Radiol. 2008;89:197–207.

    PubMed  CAS  Google Scholar 

  73. Yasuda A, Sawai H, Ochi N, et al. Solid variant of serous cystadenoma of the pancreas. Arch Med Sci. 2011;7:353–5.

    PubMed  PubMed Central  Google Scholar 

  74. Chen F, Liang JY, Zhao QY, et al. Differentiation of branch duct intraductal papillary mucinous neoplasms from serous cystadenomas of the pancreas using contrast-enhanced sonography. J Ultrasound Med. 2014;33:449–55.

    PubMed  Google Scholar 

  75. Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62:102–11.

    PubMed  Google Scholar 

  76. D’Onofrio M, et al. Contrast-enhanced ultrasonography of the pancreas. Jop. 2007;8:71–6.

    PubMed  Google Scholar 

  77. Rickes S, Wermke W. Differentiation of cystic pancreatic neoplasms and pseudocysts by conventional and echo-enhanced ultrasound. J Gastroenterol Hepatol. 2004;19:761–6.

    PubMed  Google Scholar 

  78. Kosmahl M, Pauser U, Peters K, et al. Cystic neoplasms of the pancreas and tumor-like lesions with cystic features: a review of 418 cases and a classification proposal. Virchows Arch. 2004;445:168–78.

    PubMed  CAS  Google Scholar 

  79. Paik KY, Choi SH, Heo JS, et al. Solid tumors of the pancreas can put on a mask through cystic change. World J Surg Oncol. 2011;9:79.

    PubMed  PubMed Central  Google Scholar 

  80. Tipton SG, Smyrk TC, Sarr MG, et al. Malignant potential of solid pseudopapillary neoplasm of the pancreas. Br J Surg. 2006;93:733–7.

    PubMed  CAS  Google Scholar 

  81. Volkan Adsay N. Cystic lesions of the pancreas. Mod Pathol. 2007;20:S71–93.

    Google Scholar 

  82. Kongkam P, Al-Haddad M, Attasaranya S, et al. EUS and clinical characteristics of cystic pancreatic neuroendocrine tumors. Endoscopy. 2008;40:602–5.

    PubMed  CAS  Google Scholar 

  83. Bordeianou L, Vagefi PA, Sahani D, et al. Cystic pancreatic endocrine neoplasms: a distinct tumor type? J Am Coll Surg. 2008;206:1154–8.

    PubMed  Google Scholar 

  84. Koh YX, Chok AY, Zheng HL, et al. A systematic review and meta-analysis of the clinicopathologic characteristics of cystic versus solid pancreatic neuroendocrine neoplasms. Surgery. 2014;156:e2.

    Google Scholar 

  85. Singhi AD, Chu LC, Tatsas AD, et al. Cystic pancreatic neuroendocrine tumors: a clinicopathologic study. Am J Surg Pathol. 2012;36:1666–73.

    PubMed  Google Scholar 

  86. Yoon WJ, Daglilar ES, Pitman MB, et al. Cystic pancreatic neuroendocrine tumors: endoscopic ultrasound and fine-needle aspiration characteristics. Endoscopy. 2013;45:189–94.

    PubMed  CAS  Google Scholar 

  87. Kosmahl M, Pauser U, Anlauf M, et al. Pancreatic ductal adenocarcinomas with cystic features: neither rare nor uniform. Mod Pathol. 2005;18:1157–64.

    PubMed  Google Scholar 

  88. Youn SY, Rha SE, Jung ES, et al. Pancreas ductal adenocarcinoma with cystic features on cross-sectional imaging: radiologic-pathologic correlation. Diagn Interv Radiol. 2018;24:5–11.

    PubMed  PubMed Central  Google Scholar 

  89. Oehler U, Jürs M, Klöppel G, et al. Osteoclast-like giant cell tumour of the pancreas presenting as a pseudocyst-like lesion. Virchows Arch. 1997;431:215–8.

    PubMed  CAS  Google Scholar 

  90. Colarian J, Fowler D, Schor J, et al. Squamous cell carcinoma of the pancreas with cystic degeneration. South Med J. 2000;93:821–2.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Liver, Biliary Tract and Pancreas Diseases, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutukake-cho, Toyoake, Aichi, 470-1192, Japan

    Senju Hashimoto, Yoshiki Hirooka, Naoto Kawabe, Kazunori Nakaoka & Kentaro Yoshioka

Authors
  1. Senju Hashimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoshiki Hirooka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Naoto Kawabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kazunori Nakaoka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kentaro Yoshioka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Senju Hashimoto.

Ethics declarations

Conflict of interest

The authors declare that there are no conflict of interest.

Ethical statements

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hashimoto, S., Hirooka, Y., Kawabe, N. et al. Role of transabdominal ultrasonography in the diagnosis of pancreatic cystic lesions. J Med Ultrasonics 47, 389–399 (2020). https://doi.org/10.1007/s10396-019-00975-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10396-019-00975-x

Keywords

Search

Navigation