Abstract:
Objective To investigate the routine ultrasound and contrast enhanced ultrasound (CEUS) manifestations of serous cystic adenoma (SCA) and mucinous cystic neoplasm (MCN) of the pancreas, in order to improve their diagnostic accuracy.
Methods The clinical data and conventional ultrasound and CEUS imaging data of 86 cases of SCA and MCN confirmed by surgery and pathology at Zhejiang Provincial People's Hospital from June 2016 to December 2020 were retrospectively analyzed. Univariate and multivariate Logistic regression analyses were used to evaluate the diagnostic value of clinical data as well as conventional ultrasound and CEUS characteristics in SCA and MCN.
Results There were 58 cases of SCA and 28 cases of MCN. Univariate analysis showed that there were no significant differences between SCA and MCN in gender, tumor site, tumor morphology, clinical symptoms, and enhancement intensity and mode of CEUS in the arterial phase (P＞0.05). There were statistically significant differences between the two groups in age of onset, the largest diameter of the tumor, the presence of more than six cysts in the lesion or not, the presence of calcification or not and the distribution of calcification in the lesion, the largest diameter of a single cyst more than or equal to 20 mm or not, the uniformity of the thickness of the cyst wall, the presence of cyst wall nodules or not, and the intensity of enhancement in the middle venous phase of CEUS (P＜0.05). Multivariate analysis showed that the number of cysts ≥6, non-uniform cyst wall, and the diameter of single cyst ≥20 mm were independent risk factors for the diagnosis of MCN, with odds ratio values of 0.163 (95% confidence interval [CI]: 0.047-0.561), 9.388 (95%CI: 2.663-33.094), and 3.254 (95%CI: 1.037-10.213), respectively. The Logistic regression model was as follows: Logit (P) = -2.792-1.815X3 (number of cystic cavities) + 2.239X5 (characteristics of cystic walls) + 1.180X6 (diameter of single cystic cavities). ROC curve analysis showed that the area under the curve of this regression model for identifying SCA and MCN was 0.823 (95%CI: 0.734-0.913).
Conclusion Pancreatic SCA and MCN have appreciated imaging characteristics, and ultrasound examination allows for a better differential diagnosis of the two, thus providing a basis for clinical treatment.
Key words:
Pancreas,
Neoplasms, cystic, mucinous, and serous,
Contrast-enhanced ultrasound
Yang Liu, Li Zhu, Weinan Chen, Jianchun Li, Li Wang, Ligang Wang, Xiaoming Fan, Chengzhong Peng. Value of conventional ultrasound combined with contrast-enhanced ultrasound in differential diagnosis of serous cystic adenoma and mucinous cystic neoplasm of the pancreas[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(08): 788-794.