Echo-enhanced ultrasound with pulse inversion imaging: A new imaging modality for the differentiation of cystic pancreatic tumours

Table 1 Criteria for differentiation of cystic pancreatic tumours with conventional ultrasound, fundamental power Doppler sonography, and echo-enhanced ultrasound[10,11]

	Conventional ultrasound	Fundamental powerDoppler sonography	Echo-enhancedsonography
Cystadenoma	• small cystic areas (often < 3 cm)	• no tumour vesselsdetectable	• highly vascularised tumour arteries along the fibrotic strands
	• spoke-like pattern of fibrotic strands with small calcifications
	• no dilated Wirsung's duct
Cystadeno-carcinoma	• large cystic areas (often > 5 cm)• solid areas	• rarely tumour vesselswith chaotic pattern detectable	• poorly and chaotic vascularised solid areas
	• no dilated Wirsung's duct
Pseudocyst	• often echo-free pattern	• rarely tumour vessels detectable in ”young cysts”	•”young cysts” (a few weeks of age) show often a highly vascular-ised wall
	• sharply delineated wall
	• features of acute and/or chronic pancreatitis
	• signs of bleeding and/or calcifica-tions• bowel infiltration is possible		•”old cysts” (a few months of age) show often a poorly vascularised wall