Niccolo Faccioli MD, Presenter: Nothing to Disclose

Giovanni Foti MD, Abstract Co-Author: Nothing to Disclose

Mirko D'onofrio MD, Abstract Co-Author: Nothing to Disclose

Marco Barillari, Abstract Co-Author: Nothing to Disclose

Roberto Pozzi-Mucelli MD, Abstract Co-Author: Nothing to Disclose

To compare the capability of magnetic resonance imaging (MRI) and contrast-enhanced ultrasonography (CEUS) in the detection of the imaging features of pancreatic serous cystoadenoma (PSCA) useful for characterization.

A retrospective study of 61 patients affected by PSCA studied with CEUS and dynamic MRI in the period between 2004 and 2009, was performed. The final diagnosis was achieved by surgery and pathological exam of the resected specimen. Location, size, wall (thickness, enhancement), septa (number, thickness, enhancement), presence of central scar, were retrospectively evaluated by 2 radiologists, independently. Any disagreement was resolved by consensus. The lesions were classified into 3 categories: microcystic (thin wall, numerous thin septa); macrocystic (thin wall, few thin intralesional septa); mixed micro-macrocystic. Se, sp, PPV, NPV, and accuracy were calculated with respect to the pathologic findings. A p value of 0.05 was considered statistically significant. Inter-observer variability with k agreement was determined.

MRI correctly depicted intralesional septa in 51/56 lesions (se 91.07%; sp 83.33%; PPV 96.22%; NPV 71.42%; acc 87.09%), whereas CEUS correctly depicted intralesional septa in 52/56 lesions (se 92.85%; sp 83.33%; PPV 98.11%; NPV 71.42%; acc 88.70%). MRI correctly identified central scar in 12/14 cases (se 85.71%; sp 97.87%; PPV 92.30%; NPV 96.83%; acc 95.08%), whereas CEUS in 11/14 cases (se 78.57%; sp 97.87%; PPV 91.16%; NPV 93.87%; acc 93.44%). The difference between the diagnostic accuracy of CEUS and that of MRI was not significant (p>0.05, McNemar test). MRI and CEUS showed good correlation with pathology as regards classification of lesions into categories (91.80%, 90.16%). Correlation between MRI and CEUS regarding enhancement of wall (95.08%) and septa (91.80%) was also good. Interobserver agreement had a kappa value of 0.88–0.96.  

CEUS and MRI findings well correlate with those found at pathology. CEUS may be useful in the characterization of PSCA.

CEUS may be useful in the characterization of pancreatic serous cystoadenoma, and may be proposed in the follow-up of these lesions.

Faccioli, N, Foti, G, D'onofrio, M, Barillari, M, Pozzi-Mucelli, R, Comparison of Contrast-enhanced Ultrasonography and MRI in Displaying Anatomic Features of Pancreatic Serous Cystoadenomas.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8015135.html