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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Carcinoma, Pancreatic Ductal, Contrast Media, Cystadenoma, Mucinous, Cystadenoma, Serous, Diagnosis, Differential, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Endosonography, Female, Humans, Image Enhancement, Male, Middle Aged, Neuroendocrine Tumors, Pancreas, Pancreatic Cyst, Pancreatic Neoplasms, Pancreatic Pseudocyst, Reproducibility of Results, Retrospective Studies, Sensitivity and Specificity.
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Does contrast Harmonic-Endoscopic Ultrasound be Useful to Identify Neoplastic Features of Pancreatic Cysts ( With Videos )? Context: To evaluate the potential role of contrast harmonic endoscopic ultrasound (CH-EUS) in the differential diagnosis of pancreatic cysts and detection of malignancy. Patients who underwent CH-EUS for evaluation of cyst wall, septae, and solid components of pancreatic cysts were included. The findings were compared to fine needle aspiration and surgery. Seventy-six patients were included. Serous and mucinous cysts were both hyperenhanced (86% and 89%, respectively; P = ns), whereas pseudocysts were hypoenhanced in 90% of the cases (P = 0.000004 vs serous cysts and P = 0.000005 vs mucinous cysts). Patients showing hyperenhanced solid components were finally diagnosed with malignancy (2 malignant intraductal papillary mucinous neoplasms, 2 cystic neuroendocrine tumors), in contrast to the patients with nonenhanced solid components who resulted to have either benign cysts with internal mucus clots (n = 10) or pseudocysts with internal debris (n = 8).
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CH-EUS allowed differentiation between pseudocysts and other pancreatic cysts but not mucinous versus serous cysts. Malignant vegetations inside pancreatic cystic lesions were clearly shown by CH-EUS as solid components with features of hyperenhancement, directing EUS-fine needle aspiration of potential neoplastic areas and avoiding puncture of debris and mucus plugs. Final Decision: yes