The added value of real-time harmonics contrast-enhanced endoscopic ultrasonography for the characterisation of pancreatic diseases in routine practice.

Endoscopic ultrasonography is an imaging method used in the diagnosis of pancreatic diseases. The differentiation between inflammatory tumor-like masses and pancreatic adenocarcinoma still remains difficult. Contrast enhanced harmonic endoscopic ultrasonography (CEH-EUS) is a new technique, recently available in commercial use and less evaluated. It is used to characterize the microcirculation in pancreatic disorders--hypervascularized masses such as neuroendocrine tumors or hypovascularized masses such as adenocarcinomas--and to better visualize the necrotic areas in acute pancreatitis and the vascularisation of mural nodules and septa in pancreatic cystic lesions.