Periductal hypoechoic sign: an endosonographic finding associated with pancreatic malignancy

Gastrointestinal Endoscopy
Suck-Ho LeeMandeep S Sawhney

Abstract

Despite advances in imaging, differentiating benign from malignant causes of pancreatic duct dilation is difficult. The aim of our study was to assess the accuracy of the periductal hypoechoic sign (PHS), defined as patchy hypoechoic areas adjacent to a dilated pancreatic duct, for the diagnosis of pancreatic malignancy. Single-center, retrospective analysis. Tertiary care university hospital. All patients who underwent EUS from 2006 to 2008 for evaluation of pancreatic pathology were identified. Those with pancreatic duct dilation of 4 mm or more in the head of the pancreas or 3 mm or more in the body or tail were included. Digitally recorded EUS images were analyzed for PHS by 1 endoscopist blinded to final results. The final diagnosis was based on pathology results or clinical follow-up. During the study period, 84 of 427 patients who underwent EUS for pancreas pathology had dilated pancreatic ducts. Of these, 42 patients had benign disease and 42 had pancreatic malignancy. The PHS was noted in 31 (73.8%) of 42 patients with malignancy compared with 6 (14.3%) of 42 patients with benign disease (P < .001). The PHS had a sensitivity of 73.8%, a specificity of 85.7%, and an accuracy of 79.8% for the diagnosis of pancreatic mali...Continue Reading

References

Jul 7, 2000·Gastrointestinal Endoscopy·M MengesM Zeitz
Aug 31, 2002·Radiology·Rupert W ProkeschR Brooke Jeffrey
Nov 27, 2002·Japanese Journal of Clinical Oncology·Sachiko TanakaTsugio Kitamra
Oct 26, 2005·Gastrointestinal Endoscopy·Shyam VaradarajuluMohamad A Eloubeidi
Sep 26, 2008·Pancreas·Terumi KamisawaNoriko Kamata

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Citations

Jan 11, 2013·Gastroenterology Research and Practice·Piotr LewitowiczStanisław Gluszek
Feb 28, 2014·World Journal of Gastroenterology : WJG·Jin-Seok ParkDon Haeng Lee
Feb 16, 2010·Gastrointestinal Endoscopy·John Affronti
Apr 18, 2017·The Cochrane Database of Systematic Reviews·Lawrence Mj BestKurinchi Selvan Gurusamy
Jul 12, 2011·Current Opinion in Gastroenterology·Cyrus Piraka, James M Scheiman

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