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Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery

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Multimodal endoscopic ultrasound diagnostic evaluation of pancreatic cystic lesions

https://doi.org/10.16931/1995-5464.2025-3-39-52

Abstract

Aim. To optimize the differential diagnosis of pancreatic cystic lesions by introducing novel endoscopic ultrasound (EUS) technologies into clinical practice.

Materials and Methods. The study analyzed the outcomes of multimodal diagnostic evaluation in 424 patients with pancreatic cystic lesions who underwent EUS.

Results. In 328 cases (77.4%), conventional B-mode EUS provided sufficient diagnostic information. In 96 cases (22.6%), contrast enhancement was required: 59 patients (61.5%) underwent assessment of contrast uptake by the cyst wall, septa, and solid components; 25 (26%) only by the wall and septa; and in 12 (12.5%) assessment was made ofnodular components of the pancreatic cystic lesions. Retrospective analysis demonstrated that contrast-enhanced EUS increased overall diagnostic accuracy for differentiating cystic neoplasms from post-necrotic pseudocysts by 14.7%, improved detection of solid components within cystic lesions by 11.3%, and enhanced identification of cystic adenocarcinomas or intraductal papillary mucinous neoplasms (IPMNs) associated with adenocarcinoma by 9.9%. The integration of contrast enhancement into the EUS diagnostic algorithm significantly reduced the number of fineneedle aspirations (FNA) required.

Conclusion. Both our clinical experience and data from international research underscore the necessity of incorporating multimodal EUS into the diagnostic work-up for cystic pancreatic lesions. Based on the study, an algorithm was developed for applying novel EUS technologies in the differential diagnosis of pancreatic cystic tumors.

About the Authors

E. V. Parfenchikova
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation

Elena V. Parfenchikova – Doct. of Sci. (Med.), Head of the Diagnostic Endoscopic Department

 86, Sh. Entuziastov, Moscow, 111123



D. D. Kovalenko
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation

Daria D. Kovalenko – Endoscopist of the Diagnostic Endoscopic Department

86, Sh. Entuziastov, Moscow, 111123



V. A. Kim
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation

Victoria A. Kim – Cand. of Sci. (Med.), Senior Researcher of the Diagnostic Endoscopic Department

86, Sh. Entuziastov, Moscow, 111123



K. K. Noskova
The Loginov Moscow Clinical Scientific Center
Russian Federation

Karina K. Noskova – Cand. of Sci. (Med.), Head of the Clinical Diagnostic Laboratory

86, Sh. Entuziastov, Moscow, 111123



M. V. Orlova
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation

Maria V. Orlova – Endoscopist of the Diagnostic Endoscopic Department

86, Sh. Entuziastov, Moscow, 111123



O. A. Gusarova
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation

Olga A. Gusarova – Endoscopist of the Diagnostic Endoscopic Department

86, Sh. Entuziastov, Moscow, 111123



E. V. Kostareva
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation

Ekaterina V. Kostyreva – Junior Researcher, Endoscopist of the Diagnostic Endoscopic Department

86, Sh. Entuziastov, Moscow, 111123



V. V. Shadrova
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation

Victoria V. Shchadrova – Radiologist, Department of Radiology

86, Sh. Entuziastov, Moscow, 111123



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Parfenchikova E.V., Kovalenko D.D., Kim V.A., Noskova K.K., Orlova M.V., Gusarova O.A., Kostareva E.V., Shadrova V.V. Multimodal endoscopic ultrasound diagnostic evaluation of pancreatic cystic lesions. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2025;30(3):39-52. (In Russ.) https://doi.org/10.16931/1995-5464.2025-3-39-52

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ISSN 1995-5464 (Print)
ISSN 2408-9524 (Online)