Objective:

To improve the diagnostic efficiency of contrast-enhanced ultrasound (CEUS) in pancreatic metastatic tumors (PM) through retrospective analysis of 13 PM from multiple primary origin.

Methods:

The clinical data of 13 patients with PM treated in Shanghai General Hospital from Jan. 2015 to Sep. 2019 were analyzed. All patients were examined by conventional ultrasound and CEUS before surgical resection or puncture intervention.

Results:

The primary lesion of PM were confirmed by

pathology in 11 cases

including 3 cases of lung cancer

3 cases of gastric adenocarcinoma

1 case of hepatobiliary carcinoma

1 case of thyroid follicular carcinoma

1 case of gallbladder adenocarcinoma

1 case of common bile duct adenocarcinoma and 1 case of renal clear cell carcinoma. The primary lesions of rest 2 PM were diagnosed as peritoneal tumors and hepatocellular carcinoma by clinical history and imaging examination. Conventional ultrasound showed that most of the PM were hypoechoic masses with clear boundaries

and the echoes were homogeneous. Color Doppler flow imaging showed that only 4 cases had abundant blood flow signals. On CEUS images

7 cases showed centripetal enhancement

and 6 cases showed overall enhancement. In the arterial phase

7 cases appeared as hyper-enhancement and the other 6 showed hypo-enhancement. In the venous phase

11 cases showed hypo-enhancement and only 2 cases showed hyper-enhancement.

Conclusion:

Centripetal enhancement was a more specific enhancement pattern of PM. PM could be represented as hypervascular or hypovascular based on different origin of primary lesion.