Can Ultrasound be Used as an Alternative Tool for Pancreatic Cystic Disease Compared With MRI?

To analyze the ultrasound features of pancreatic cystic lesions and to compare contrast-enhanced sonography (CEUS) with magnetic resonance imaging (MRI) to investigate the diagnostic value of CEUS for pancreatic cystic lesions.

Patients with pancreatic cystic lesions who underwent CEUS examination and enhanced MRI from February 2022 to January 2023 at Peking Union Medical College Hospital were prospectively included. The diagnostic value of CEUS in the diagnosis of pancreatic cystic lesions was analyzed using postoperative histopathology as the gold standard and compared with enhanced MRI.

In total, 17 patients with pancreatic cystic lesions were included, the CEUS diagnostic accuracy was 76.47% (13/17), the enhanced MRI diagnostic accuracy was 64.71% (11/17), and the diagnostic results of CEUS were in moderate agreement with those of enhanced MRI (κ = 0.52). The CEUS features of all lesions were categorized into four types: Type I, unilocular cystic type, five cases; Type II, microcystic lesion type, four cases; Type III, macrocystic lesion type, two cases; and Type IV, lesion with an enhanced solid component, six cases. There were two cases of Type I and one case of Type II simple cysts. Pancreatic pseudocysts were Type I in one case. Of the pancreatic serous cystadenomas, three cases were Type II, two cases were Type III, and one case was Type IV. The case of pancreatic mucinous cystadenoma was Type I. For the intraductal papillary mucinous neoplasm, four cases were all Type IV. For solid pseudopapillary tumors of the pancreas, one case was classified as Type IV. One case of pancreatic neuroendocrine tumor was classified as Type I.

CEUS, as an economical, radiation-free, and effective imaging modality, can be an optional test for pancreatic cystic diseases and helps in their diagnosis and follow-up.