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Published on: January 27, 2011
A Preliminary Study on Contrast Enhanced Ultrasound Characteristics of Solid Pseudopapillary Neoplasms and
Yuxin Tang1, Juan Wang2, Lirong Zhu1
1Department of Ultrasound, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child and Adolescents' Health and Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Municipal Health Commission Key Laboratory of Chidren's Vital Organ Development and Diseases, Chongqing 400010, China.
Insights
Contrast-enhanced ultrasound (CEUS) can help differentiate pediatric solid pseudopapillary neoplasms (SPN) and pancreatoblastoma (PB). PB shows rapid, high enhancement with chaotic vessels and washout, while SPN has moderate, slow enhancement, often with cystic features.
Area of Science:
- Pediatric oncology
- Medical imaging
- Gastroenterology
Background:
- Solid pseudopapillary neoplasms (SPN) and pancreatoblastoma (PB) are rare but common pancreatic tumors in children.
- There is a need for systematic descriptions of contrast-enhanced ultrasound (CEUS) features for these pediatric pancreatic tumors.
- Differentiating SPN and PB in pediatric patients can be challenging.
Purpose of the Study:
- To retrospectively analyze and compare the CEUS characteristics of pediatric SPN and PB.
- To identify key imaging differentiation points between SPN and PB using CEUS.
- To explore novel hemodynamic clues for differentiating these rare pediatric pancreatic tumors.
Main Methods:
- Retrospective analysis of 22 pediatric patients with pathologically diagnosed SPN or PB.
- Qualitative and quantitative analysis of CEUS imaging findings, including time-intensity curve (TIC) analysis.
- Inter-observer consistency analysis was performed to ensure measurement reliability.
Main Results:
- Significant differences in age and Ki-67 index were observed between SPN and PB groups.
- SPN showed heterogeneous enhancement patterns, often with capsular enhancement and cystic components.
- PB consistently displayed 'disorganized nourishing vessels' sign with numerically higher peak enhancement (IMAX) and faster washout trends.
Conclusions:
- CEUS reveals distinct hemodynamic characteristics differentiating pediatric SPN and PB.
- PB typically presents with rapid, high enhancement and chaotic vascularity, while SPN shows moderate, slower enhancement.
- These preliminary findings require validation in larger studies due to the small sample size of PB cases.
Abstract:
Objective: Solid pseudopapillary neoplasms (SPN) and pancreatoblastoma (PB) have a low overall incidence but represent the most common pancreatic tumors in childhood. Currently, there is a lack of systematic descriptions of contrast-enhanced ultrasound (CEUS) features for these two tumors in pediatric populations. This study aims to retrospectively analyze and compare the CEUS characteristics of SPN and PB to explore key imaging differentiation points. Methods: This retrospective study collected data on 22 patients with solid pseudopapillary neoplasms and pancreatic blastomas of the pancreas who were pathologically diagnosed at a children's hospital between September 2019 and May 2025. The ultrasound contrast-enhanced imaging findings for both tumor types were summarized and analyzed. Two physicians with different levels of experience performed qualitative analysis of the contrast-enhanced images, while quantitative analysis was conducted using time-intensity curve (TIC) analysis software. Results: This study included a total of 22 pediatric patients (19 with SPN and 3 with PB). Significant differences existed between the two groups in age (13.51 years vs. 2.94 years) and Ki-67 index (5.00% vs. 30.00%). Qualitative analysis revealed high heterogeneity in SPN enhancement patterns, with capsular enhancement with cystic components being the most common (42.11%). All PBs (100%) consistently demonstrated the "disorganized nourishing vessels" sign. Quantitative analysis revealed that PBs exhibited numerically higher IMAX values (179.84% vs. 60.56%) and faster WoR trends (773.88 vs. 275.38). Inter-observer consistency analysis supported measurement reliability (key parameters ICC > 0.80). Conclusions: This preliminary study indicates differences in CEUS characteristics between pediatric SPN and PB; PB tends to exhibit rapid, high enhancement with chaotic feeding vessels and rapid washout, whereas SPN more commonly presents with moderate, slow enhancement patterns, often accompanied by features associated with cystic components. These findings provide new hemodynamic clues for their imaging differentiation. Given the extremely small sample size of PB cases, the above conclusions should be regarded as preliminary hypotheses awaiting validation in future large-scale studies.
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