[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-331963-en":3,"doc-seo-331963-105":31,"detail-sidebar-cat-0-en-105":99},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":28,"seo_description":14,"update_tm":29,"read_time":30},331963,8796095360427,"Lucas Martin","https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d",7,"Healthcare","Role of Contrast-Enhanced Harmonic Endoscopic Ultrasonography (EUS) and EUS Elastography in Pancreatic Lesions - Review","This review examines how contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) and EUS elastography improve characterization of pancreatic lesions. It addresses limitations of conventional EUS, where most solid lesions are hypoechoic and differential diagnosis is difficult. CH-EUS evaluates lesion vascularity using microbubble-based harmonic signals and can support quantitative assessment via time-intensity curves. EUS elastography measures tissue elasticity, using either strain elastography or shear-wave elastography. The review highlights applications for differentiating solid and cystic lesions and for pancreatic cancer staging, and notes advantages over contrast-enhanced CT or MRI when contraindications exist.","REVIEW  \nClin Endosc 2024;57:164-174 [https://doi.org/10.5946/ce.2023.074](https://doi.org/10.5946/ce.2023.074)  \n[pISSN: 2234-2400](pISSN: 2234-2400) • eISSN: 2234-2443  \nOpen Access  \nRole of contrast-enhanced harmonic endoscopic ultrasonography (EUS) and EUS elastographyin pancreatic lesions  \nYasunobu Yamashita, Masayuki Kitano  \nSecond Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan  \nPancreatic cancers have a poor prognosis, and their incident rates have risen. Endoscopic ultrasonography (EUS) is an efficient and reliable diagnostic modality for pancreatic lesions, providing high spatial resolution. However, while EUS helps to detect minor pancreatic lesions, nearly all solid pancreatic lesions are hypoechoic, which creates difficulty in making differential diagnoses of pancreatic lesions. When diagnosing pancreatic lesions, the performance of image-enhanced EUS techniques is essential, such as EUS elastography or contrast-enhanced harmonic EUS (CH-EUS) . CH-EUS diagnosis is based on assessing the vascularity of lesions, whereas tissue elasticity is measured via EUS elastography. Elastography is either strain or shear-wave, depending on the different mechanical properties being evaluated. The usefulness of enhanced EUS techniques is demonstrated in this review for the differential diagnosis of pancreatic lesions, including solid and cystic lesions, and pancreatic cancer staging.  \nKeywords: Contrast-enhanced endoscopic ultrasonography; Elastography; Endosonography; Pancreatic lesion; Staging of pancreatic cancer  \nINTRODUCTION  \nWhen performing transabdominal ultrasound imaging, intervening gas, bone, and fat can create problems. Endoscopic ultrasonography (EUS) was developed as a solution. It also attains high spatial resolution imaging. EUS generally has a high spatial resolution.1-4 However, conventional EUS is subject to limitations in the differential diagnosis of pancreatic lesions because most solid lesions appear as hypoechoic masses. Evalu-  \nReceived: March 4, 2023 Revised: May 12, 2023  \nAccepted: May 14, 2023  \nCorrespondence: Masayuki Kitano  \nSecond Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 641-0012, Japan [E-mail:](E-mail: kitano@wakayama-med.ac.jp)[ kitano@wakayama-med.ac.jp](E-mail: kitano@wakayama-med.ac.jp)  \n This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([http://creativecommons.org/licenses/by-nc/4.0/](http://creativecommons.org/licenses/by-nc/4.0/)) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.  \nating the pancreatic lesions’ vascularity and tissue elasticity offers ways to improve their characterization. In clinical practice, contrast-enhanced harmonic EUS (CH-EUS) and EUS elastography have become increasingly used as adjunctive methods for characterizing pancreatic lesions. CH-EUS is based on assessing vascularity with contrast agents, whereas EUS elastography measures tissue elasticity. EUS elastography has two broad types according to the different mechanical properties under evaluation: shear-wave elastography (SWE) and strain elastography. CH-EUS and EUS elastography are increasingly being used in the differential diagnosis of pancreatic lesions, offering benefits over contrast-enhanced computed tomography (CT) and magnetic resonance imaging in cases in which there are contraindications to these modalities, such as those with patients with renal failure and patients with contrast allergy. Dynamic and repeat examinations are also possible. This review updates the literature on the present-day applications of these enhanced EUS imaging techniques.  \n164 © 2024 Korean Society of Gastrointestinal Endoscopy  \nYamashita et al. Enhanced EUS for pancreatic lesions  \nPRINCIPLES OF IMAGE-ENHANCEDEUS  \nCH-EUS  \nWe describe the concepts of contrast harmo","cbCaisNa8F6Q5X7E","https://ap.wps.com/l/cbCaisNa8F6Q5X7E","pdf",1724125,12,1,11,"English","en",105,"# Introduction\n# Principles of Image-Enhanced EUS\n## CH-EUS\n## EUS Elastography\n### Strain elastography","[{\"question\":\"Why is conventional EUS limited for diagnosing pancreatic lesions?\",\"answer\":\"Most solid pancreatic lesions appear hypoechoic on conventional EUS, making differential diagnosis difficult.\"},{\"question\":\"What does CH-EUS evaluate in pancreatic lesions?\",\"answer\":\"CH-EUS evaluates lesion vascularity by analyzing harmonic signals generated from microbubbles in contrast agents.\"},{\"question\":\"How does EUS elastography contribute to lesion assessment?\",\"answer\":\"EUS elastography measures tissue elasticity, using strain elastography or shear-wave elastography depending on the mechanical property being evaluated.\"}]","Role of Contrast-Enhanced Harmonic Endoscopic Ultrasonography (EUS) and EUS Elastography in Pancreatic Lesions - 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