Ultrasonography of the Pancreas: Imaging and Pathologic Correlations

ISBN-13: 9788847023789 / Angielski / Twarda / 2011 / 202 str.

D'Onofrio, Mirko

Opis

Ultrasonography (US) has long been considered an important diagnostic imaging modality for investigation of the pancreas despite certain significant and well-known limitations. Indeed, in many countries US represents the first step in the diagnostic algorithm for pancreatic pathologies. Recent years have witnessed major advances in conventional, harmonic, and Doppler imaging.New technologies, softwares, and techniques, such as volumetric imaging, enhancement quantification, and fusion imaging, are increasing the diagnostic capabilities of US. The injection of microbubble contrast agents allows better tissue characterization with definitive differentiation between solid and cystic lesions. Contrast-enhanced US improves the characterization of pancreatic tumors, assists in local and liver staging, and can offer savings in both time and money. Acoustic radiation force impulse (ARFI) imaging is a promising new US method to test, without manual compression, the mechanical strain properties of deep tissues. Furthermore, the applications and indications for interventional, endoscopic, and intraoperative US have undergone significant improvement and refinement.This book provides a complete overview of all these technological developments and their impact on the assessment of pancreatic pathologies. Percutaneous, endoscopic, and intraoperative US of the pancreas are discussed in detail, with precise description of findings and with informative imaging (CT and MRI) and pathologic correlations.

For many years, ultrasonography (US) of the pancreas has been considered an important diagnostic imaging modality, although with significant well-known limitations. Major advances have occurred in conventional, harmonic, and Doppler imaging. Currently, US, together with tissue harmonic imaging (THI) and Doppler study, usually represents the first step in the diagnostic algorithm of pancreatic pathologies. In the pancreas, the contribution of contrast media to the detection and characterization of both solid and cystic exocrine and endocrine pancreatic neoplasms is increasing. The introduction of microbubble contrast agents allows a definitive differentiation between solid and cystic lesions, and contrast-enhanced ultrasonography (CEUS) has improved the characterization of pancreatic tumors together with their local and liver staging.To overcome subjectivity, the use of quantification software has been suggested for the characterization of pancreatic lesions during CEUS study, as recently reported in literature.§Furthermore, the applications and indications for interventional, endoscopic, and intraoperative US have significantly improved in the last year, as a result of technological advances. There has been increasing interest in the study of the visco-elastic properties of tissues over the last few decades. The earliest imaging techniques, such as elastography and sonoelasticity, only allowed evaluation of superficial tissues, and required external compression. Acoustic radiation force impulse (ARFI) imaging is a promising new ultrasound method to test the mechanical strain properties of deep tissues, with no requirement for external compression. This new technique seems to be potentially able to allow tissue characterization, and to represent a feasible alternative to invasive needle biopsy.§All these technological developments in the field of ultrasound justify a complete overview and precise description, as is given in this book.

Recenzje

From the reviews:

"The book Ultrasonography of the Pancreas represents the state of the art in this field and is the result of the contribution of a group of authors of internationally renowned authors and, primarily, of the editor. ... The text is supported by a large number of excellent-quality images ... . the book provides a complete and updated overview of the status and potential of modern US techniques for use in pancreatic imaging." (Roberto Pozzi Mucelli, La Radiologia Medica, Vol. 117, 2012)

Spis treści

1. Ultrasound Imaging - 2. Transabdominal Ultrasonography of the Pancreas - 3. Endoscopic Ultrasonography of the Pancreas - 4. Percutaneous Ultrasound Guided Interventional Procedures in Pancreatic Diseases - 5. Intraoperative Ultrasonography of the Pancreas - 6. Pancreatic Anatomy, Variants and Pseudolesions of the Pancreas - 7. Pancreatitis and Pseudocysts - 8. Solid Pancreatic Tumors - 9. Cystic Pancreatic Tumors - 10. Rare Pancreatic Tumors - 11. Imaging Correlation - 12. Pancreatic Lesions: Pathologic Correlations - 13. Clinical and Imaging Scenarios - 14. Flowcharts in Pancreatic Diseases.

O autorze

G. B. Rossi University Hospital is a referral center specialized in pancreatic diseases. In 2006, the Department of Radiology performed more than 900 contrast-enhanced ultrasound examinations, half of which were for pancreatic pathologies, and 200 ultrasound-guided biopsies for pancreatic masses. Dr D’Onofrio has renowned international experience in pancreatic disease management and in the use of contrast-enhanced ultrasound. All ultrasound studies of pancreatic lesions need to be correlated with the findings of other imaging modalities in order to reach a final diagnosis. A complete description of the correlations between ultrasound-imaging and ultrasound-pathologic findings will lead to an improvement of the diagnostic capability of ultrasound in studying pancreatic pathologies. Dr D’Onofrio has been working since 2004 as a university researcher in the Department of Radiology at the University of Verona in the University Hospital of G. B. Rossi. He has been an associate of SIRM (Italian Society of Medical Radiology) and AISP (Italian Association for the Study of the Pancreas) since 2002 and is a member of the editorial board of the official journal of SIRM. He has been a faculty member of IBISCUS (International Bracco Imaging School for Contrast-Enhanced Ultrasound) since 2003. He is an associate of SIUMB (Italian Society of Ultrasound in Medicine and Biology) and EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) and a member of ESGAR (European Society of Gastrointestinal and Abdominal Imaging). He is the chairman for pancreatic applications of contrast-enhanced ultrasound in the EFSUMB guidelines and for the good clinical practice recommendation in contrast-enhanced ultrasound meetings update 2007. Dr D’Onofrio is author of more than 40 original papers in Italian and international medical journals and of 7 book chapters; he is also the author of the book Ecografia e procedure interventistiche percutanee, published by Springer in 2008. In addition, he is a reviewer for AJR. American Journal of Roentgenology, Pancreas, CMAJ: Canadian Medical Association Journal, BMC Cancer, and La Radiologia Medica.

Blurb

Ultrasonography (US) has long been considered an important diagnostic imaging modality for investigation of the pancreas despite certain significant and well-known limitations. Indeed, in many countries US represents the first step in the diagnostic algorithm for pancreatic pathologies. Recent years have witnessed major advances in conventional, harmonic, and Doppler imaging.

New technologies, softwares, and techniques, such as volumetric imaging, enhancement quantification, and fusion imaging, are increasing the diagnostic capabilities of US. The injection of microbubble contrast agents allows better tissue characterization with definitive differentiation between solid and cystic lesions. Contrast-enhanced US improves the characterization of pancreatic tumors, assists in local and liver staging, and can offer savings in both time and money. Acoustic radiation force impulse (ARFI) imaging is a promising new US method to test, without manual compression, the mechanical strain properties of deep tissues. Furthermore, the applications and indications for interventional, endoscopic, and intraoperative US have undergone significant improvement and refinement.

This book provides a complete overview of all these technological developments and their impact on the assessment of pancreatic pathologies. Percutaneous, endoscopic, and intraoperative US of the pancreas are discussed in detail, with precise description of findings and with informative imaging (CT and MRI) and pathologic correlations.