Hydatid cyst of the pancreas: Report of an undiagnosed case of pancreatic hydatid cyst and brief literature review

Hydatid cyst of the pancreas: Report of an undiagnosed case of pancreatic hydatid cyst and brief literature review.

Usefulness of contrast-enhanced ultrasonography using Sonazoid for the assessment of therapeutic response to percutaneous radiofrequency ablation for hepatocellular carcinoma

Background The aim of this study was to assess the diagnostic performance of radiological imaging in differentiating xanthogranulomatous cholecystitis (XGC) from gallbladder cancer (GBC). Methods A retrospective analysis of the radiological imaging performed in patients who had pathologically confirmed XGC or GBC between December 2004 to April 2016 was performed. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each imaging modality, and combined imaging modalities were calculated. Results A total of 218 patients (XGC =109, GBC =109) were identified; 19 patients received all of abdominal ultrasound (US), contrast-enhanced ultrasound (CEUS), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET/CT); 21 received four of these imaging examination types; 45 received three examinations; 58 received two examinations; and 75 received only one examination. The sensitivity and specificity of CEUS was 90% and 93%, respectively, higher than abdominal US (80%, 86%), CT (71%, 92%), MRI (75%, 90%), and PET/CT (55%, 90%) (all values respective). The sensitivity, specificity, NPV, and PPV of the US combined with CEUS were 91%, 90%, 94%, and 85%, respectively. Although the specificity of CEUS + CT and CEUS + MRI were 100% and 92%, respectively, the sensitivity of CEUS + CT and CEUS + MRI were both only 67%. Conclusions The Abdominal US is not sufficiently accurate to confidently guide clinical practice, and CEUS showed better diagnostic performance than the other imaging modalities in differentiating XGC from GBC. The combination of abdominal CEUS and CT is helpful for differential diagnosis, as it indicates GBC with better specificity and PPV.

Diagnostic accuracy of imaging modalities in differentiating xanthogranulomatous cholecystitis from gallbladder cancer

The purpose of this study was to assess the efficacy of conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) in guiding and assessing early therapeutic response to radiofrequency (RF) ablation for hepatocellular carcinomas (HCCs; up to 3 lesions, each ≤3 cm in diameter) and to report the short-term follow-up results. Between September 2011 and January 2013, 63 patients with 78 HCCs (≤3 cm) underwent conventional US- and CEUS-guided percutaneous RF ablation. CEUS was repeated after 20–30 min to assess therapeutic response, and local efficacy was further confirmed by contrast-enhanced magnetic resonance imaging (MRI) 1 mo after tumor ablation. Patients were followed periodically to look for local tumor or disease progression. Survival probability was estimated with the Kaplan–Meier method. Complete ablation was achieved for 76 (97.4%) of 78 HCCs in one (n = 73) or two (n = 3) sessions. No major complications were observed in any patient. The overall concordance in assessment of therapeutic efficacy of RF ablation between CEUS and MRI was 97.4% (76/78 tumors). The concordance test gave a value of κ = 0.74 ( p

Radiofrequency ablation for hepatocellular carcinoma: utility of conventional ultrasound and contrast-enhanced ultrasound in guiding and assessing early therapeutic response and short-term follow-up results.

Objectives The purpose of this study was to differentiate perfusion and vascular characteristics between benign and malignant breast lesions by 3-dimensional contrast-enhanced sonography and evaluate their correlation with microvessel density and vascular endothelial growth factor (VEGF) expression for further clinical exploration. Methods Three-dimensional contrast-enhanced sonography was performed in 183 patients with breast lesions, and sonographic characteristics were carefully observed for further analysis. The mean microvessel density and VEGF expression were measured by immunohistochemical analysis. Results Pathologic results showed 35 benign and 148 malignant cases. Malignancy and benignity differed significantly in peripheral vessel characteristics (number, distribution, course, degree of dilatation, and penetrating vessels), rim perfusion and coarseness degree, intratumoral perfusion type, and intratumoral vessel dilatation (P .05). The specificity of penetrating vessels was 88.6% for diagnosing malignancy. The sensitivity, specificity, and accuracy of rim perfusion coarseness were 90.2%, 70.4%, and 85.3% respectively. The sensitivity of the intratumoral perfusion type was 77.8%, whereas the specificity of intratumoral vessel dilatation was 88.9%. Microvessel density and VEGF expression were significantly correlated with perfusion and vascular characteristics (P .05). The presence of intratumoral vessels was related to VEGF (P .05). Conclusions Three-dimensional contrast-enhanced sonographic characteristics were statistically different between benign and malignant breast lesions. Some of them also correlated significantly with microvessel density and VEGF expression and therefore have potential for objective evaluation of tumor angiogenesis.

https://onlinelibrary.wiley.com/doi/pdf/10.7863/ultra.33.5.835

Three-dimensional contrast-enhanced sonography in the assessment of breast tumor angiogenesis: correlation with microvessel density and vascular endothelial growth factor expression.

Percutaneous ablative methods guided by imaging techniques are considered nowadays curative treatment for early HCC in patients who are not candidates for liver transplantation and surgical resection. The final goal of all ablative treatments is to achieve complete destruction of neoplastic tissue by disruption of tumor vascularity. The best way to demonstrate the efficacy of any ablative methods noninvasively is to demonstrate that the blood supply has been disrupted both inside and at the periphery of the tumor by means of imaging methods. Contrast-enhanced ultrasound (CEUS) with second generation contrast agents is almost as sensitive as CT (considered to be the gold standard) in depicting the residual tumor after an ablation. Moreover, CEUS can be used before ablation to plan the treatment, during the procedure to guide the needle insertion, or immediately after to determine whether the tumor has been ablated or needs additional treatment which can be performed in the same session.

/pdf/contrast-enhanced-ultrasound-in-assessing-therapeutic-1geujaz3uf.pdf

Contrast-Enhanced Ultrasound in Assessing Therapeutic Response in Ablative Treatments of Hepatocellular Carcinoma

Pancreatic localization of hydatid cyst is uncommon. We report a case of a 49-year-old woman who presented with abdominal discomfort, nausea and vomiting. The diagnosis of pancreatic cyst with splenomegaly and portal hypertension was supported on ultrasound, CT-scan and endoscopic ultrasound. Surgical treatment confirmed the hydatid cyst, and included distal pancreatectomy and splenectomy. The recovery was uneventful and the patient remained symptoms free.

Hydatid cyst of the pancreas causing portal hypertension

Poster: "ECR 2010 / C-1378 / Usefulness of contrast enhanced ultrasound guided biopsy in large renal and adrenal tumors: Preliminary experience" by: "Z. Sparchez, P. Radu, T. Zaharia, R. Badea, G. Kacso; Cluj-Napoca/RO"

Usefulness of contrast enhanced ultrasound guided biopsy in large renal and adrenal tumors: Preliminary experience

Poster: "ECR 2012 / C-1023 / The combined role of intravenous contrast enhanced ultrasound (CEUS) and computed tomography (CT) in liver abscess diagnosis" by: "D. S. Feier1, M. Socaciu2, N. Al Hajjar3, O. Anton3, R. Badea3; 1Cluj Napoca/RO, 2Cluj Napoca, Cl/RO, 3Cluj-Napoca/RO"

/pdf/the-combined-role-of-intravenous-contrast-enhanced-1n12u7t2gy.pdf

The combined role of intravenous contrast enhanced ultrasound (CEUS) and computed tomography (CT) in liver abscess diagnosis.

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Contrast-Enhanced Ultrasound in Assessing Therapeutic Response in Ablative Treatments of Hepatocellular Carcinoma

Hydatid cyst of the pancreas causing portal hypertension

Usefulness of contrast enhanced ultrasound guided biopsy in large renal and adrenal tumors: Preliminary experience

The combined role of intravenous contrast enhanced ultrasound (CEUS) and computed tomography (CT) in liver abscess diagnosis.