Echo-enhanced color- and power-Doppler EUS for the discrimination between focal pancreatitis and pancreatic carcinoma

Gastrointest Endosc. 2001 Jun;53(7):784-9. doi: 10.1067/mge.2001.115007.


Background: EUS is a precise method for detection and staging of pancreatic tumors. However, differentiation between inflammatory pseudotumor and pancreatic carcinoma remains difficult. The aim of this study was to evaluate contrast-enhanced EUS as a method of differentiating inflammation and carcinoma based on perfusion characteristics.

Methods: Patients with solid pancreatic masses underwent EUS with a linear echoendoscope. Perfusion in the pancreatic tissue and the mass was assessed with native and contrast-enhanced EUS with power- and color-Doppler imaging. Examinations were evaluated by a blinded reader. A markedly hyperperfused lesion was considered an inflammatory pseudotumor whereas lesions that were hypoperfused compared with surrounding tissue were considered to be carcinoma.

Results: Fifteen of 23 patients had hypoperfusion within the mass and 8 patients had hyperperfused lesions. Of the 15 patients with hypoperfused masses, all had pancreatic adenocarcinoma; 1 of 8 patients with a hyperperfused lesion also had adenocarcinoma. The remaining 7 patients had focal inflammation. Sensitivity for differentiation of pancreatic carcinoma versus inflammatory changes was 94%, specificity 100%.

Conclusion: Echo-enhanced power-Doppler EUS reliably differentiates pancreatic neoplasm and focal pancreatitis. The diagnostic accuracy of this technique is comparable to CT, magnetic resonance imaging, positron emission tomography, and ERCP.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adenocarcinoma / diagnostic imaging*
  • Adenocarcinoma / pathology
  • Adult
  • Aged
  • Albumins
  • Cholangiopancreatography, Endoscopic Retrograde
  • Contrast Media
  • Diagnosis, Differential
  • Endosonography / methods*
  • Female
  • Fluorocarbons
  • Granuloma, Plasma Cell / diagnostic imaging*
  • Granuloma, Plasma Cell / pathology
  • Humans
  • Image Enhancement / methods
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatitis / diagnostic imaging*
  • Pancreatitis / pathology
  • Sensitivity and Specificity
  • Ultrasonography, Doppler, Color
  • Ultrasonography, Doppler, Pulsed


  • Albumins
  • Contrast Media
  • FS 069
  • Fluorocarbons