Maximizing the endosonography: The role of contrast harmonics, elastography and confocal endomicroscopy

Table 2 Description of solid and cystic pancreatic lesions during harmonic contrast-enhanced endoscopic ultrasound examination

		Enhancement	Pattern of distribution	Wash-out
Solid pancreatic lesion	Adenocarcinoma	Hypoenhanced	Homogenous/non-homogenous	Fast
	NET	Hyperenhanced > hypoenhanced	Homogenous/non-homogenous	Slow > Fast
	Chronic pancreatitis	Isoenhanced/hyperenhanced > hypoenhanced	Homogenous/non-homogenous	Fast
	Autoimmune pancreatitis	Isoenhanced/hyperenhanced	Homogenous/non-homogenous	Fast
Cystic pancreatic lesion	SCA	Hyperenhancement of the vascularized septae,	Homogenous	Slow
		honeycomb aspect highlighted
	MCN	Hyperenhanced thick walls, thick septa and nodules are predictive for malignancy		Fast
	Pseudocyst	Avascular wall +		-
		solid component without any contrast uptake
	IPMN	Hyperenhanced septae and vascularized neoplastic nodules		Fast
	NET cystic	Hyperenhanced wall and vascularized nodules		Slow

NET: Neuroendocrine tumor; SCA: Serous cystadenoma; MCN: Mucinous cystic neoplasm; IPMN: Intraductal papillary mucinous neoplasm.