Qualitative and quantitative contrast-enhanced ultrasonographic assessment of cerulein-induced acute pancreatitis in dogs

Abstract

Background: Acute pancreatitis (AP) is the most common disease of the canine exocrine pancreas, and accurate noninvasive diagnosis is challenging.

Hypothesis/objectives: To determine the feasibility of using quantitative contrast-enhanced ultrasonography (CEUS) to detect pancreatic perfusional changes in cerulein-induced AP in dogs.

Animals: Six adult female Beagles.

Methods: Each dog received 2 hours of IV infusion with 7.5 μg/kg/h of cerulein diluted in saline. As control, all dogs received 2 hours of IV infusion of saline 2 weeks before cerulein infusion. CEUS of the pancreas and duodenum were performed before (0 hour), and at 2, 4, 6, and 12 hours after saline and cerulein infusion. Time-intensity curves were created from regions of interest in the pancreas and duodenum. Five perfusional parameters were measured for statistical analysis: time to initial up-slope, peak time, time to wash-out, peak intensity (PI), and area under the curve (AUC).

Results: In cerulein-induced AP, pancreatic PI increased at 2 and 4 hours when compared to 0 hour, and at 2, 4, and 6 hours when compared to control. AUC increased at 4 hours when compared to 0 hour, and at 2 and 4 hours when compared to control. Time to wash-out was prolonged at 4 hours when compared to control. For saline control, peak time was faster at 2 hours when compared to 0 hour.

Conclusions and clinical importance: CEUS parameters PI and AUC can provide useful information in differentiating acute pancreatitis from normal pancreas. Cerulein-induced AP was characterized by prolonged hyperechoic enhancement on CEUS.

Keywords: Contrast-ultrasound; Inflammation; Pancreas; Perfusion.