Year 2025 / Volume 117 / Number 7
Original
Evaluation of pancreatic microvascularization in chronic pancreatitis by endoscopic ultrasound-guided detective flow imaging: a prospective, single-center, observational study

382-388

DOI: 10.17235/reed.2025.11054/2025

Yessica Domínguez-Novoa, Enrique Domínguez-Muñoz, Xurxo Martínez-Seara, José Lariño-Noia, Julio Iglesias-García,

Abstract
Introduction: early diagnosis of chronic pancreatitis (CP) is a clinical challenge. Endoscopic ultrasound-guided detective flow imaging (EUS-DFI) can evaluate pancreatic microvascularization, which may be altered in chronic inflammation. This study aimed to evaluate EUS-DFI findings in patients with CP. Methods: prospective, single-center, observational study including patients undergoing EUS for known or clinically suspected CP. EUS criteria for CP were evaluated according to the Rosemont classification. EUS-DFI findings were analyzed and classified into three grades: grade 0 = absence of microvasculature; grade 1 = reticular pattern with mild microvascularization; and grade 2 = reticular pattern with marked microvascularization. The correlation between EUS-DFI and Rosemont classification was analyzed. Results: two hundred and five patients (mean age 53 years, range 21-85, 107 males) were included. Thirty-four patients (16.6 %) had a normal pancreas, 55 (26.7 %) indeterminate findings of CP, 108 (52.7 %) suggestive changes of CP and eight (4.0 %) consistent with CP. EUS-DFI grade 0 was only seen in subjects with a normal pancreas, whereas an EUS-DFI grade 1 was usually associated with indeterminate and suggestive findings of CP (97.6 % of cases). Grade 2 was observed in some patients with suggestive CP and in all patients with definite findings of CP (p < 0.001). EUS-DFI was significantly different between groups according to Rosemont classification (p < 0.001). Conclusion: EUS-DFI allows the assessment of pancreatic microvascularization in CP, which correlates with the severity of morphological changes of the disease.
Lay Summary
Early diagnosis of chronic pancreatitis is a clinical challenge. This study aimed to evaluate a new imaging method (Endoscopic ultrasound-guided detective flow imaging (EUS-DFI), that allows the detection of small vessels (microvascularization) in the diagnosis of this disease. According to the stage of chronic pancreatitis (classified according to Rosemont classification), EUS-DFI findings were analyzed and classified into three grades (0-2), according to the presence or absence of vascularization. EUS-DFI grade 0 was only seen in subjects with a normal pancreas, whereas an EUS-DFI grade 1 was usually associated with indeterminate and suggestive findings of chronic pancreatitis, and grade 2 was observed in some patients with suggestive and in all patients with consistent findings of chronic pancreatitis. EUS-DFI allows the assessment of pancreatic microvascularization, which correlates with the severity of the disease.
New comment
Comments
No comments for this article
Related articles

Letter

Deceiving duodenal erosion: a fishbone lies beneath

DOI: 10.17235/reed.2024.10872/2024

Letter

Duodenal lymphangiomas: endoscopic ultrasound features

DOI: 10.17235/reed.2024.10338/2024

Letter

Spontaneous cystogastric fistula: an accidental discovery

DOI: 10.17235/reed.2023.9912/2023

Digestive Diseases Image

Imaging of pancreatic desmoid fibromatosis by endoscopic ultrasound

DOI: 10.17235/reed.2023.9792/2023

Letter

Calcifying fibrous tumor and pathological analysis

DOI: 10.17235/reed.2023.9739/2023

Letter

Endoscopic observation of a rare duodenal tumor

DOI: 10.17235/reed.2023.9679/2023

Editorial

Recent advances in the diagnosis and management of Wilson’s disease

DOI: 10.17235/reed.2023.9633/2023

Letter

Vaginal lesion as first manifestation of colorectal disease

DOI: 10.17235/reed.2022.9270/2022

Digestive Diseases Image

Endosonographic and ERCP findings in COVID-19 critical illness cholangiopathy

DOI: 10.17235/reed.2022.9218/2022

Letter

Angiosarcoma of the aorta diagnosed via endoscopic ultrasound

DOI: 10.17235/reed.2022.8879/2022

Digestive Diseases Image

Pancreatic lymphoma during pregnancy

DOI: 10.17235/reed.2022.8811/2022

Digestive Diseases Image

An unusual cause of a protuberant lesion of the gastric antrum

DOI: 10.17235/reed.2022.8771/2022

Digestive Diseases Image

When needles are not enough, forceps delivers!

DOI: 10.17235/reed.2022.8697/2022

Letter

Sigmoid colon Schwannoma simulating colon cancer

DOI: 10.17235/reed.2022.8684/2022

Digestive Diseases Image

Abdominal cocoon sign: an unusual cause of intestinal obstruction

DOI: 10.17235/reed.2021.8057/2021

Letter

POEMS syndrome: an uncommon cause of peritoneal effusion

DOI: 10.17235/reed.2021.8027/2021

Digestive Diseases Image

Phlebosclerotic colitis: an unusual cause of abdominal pain and hematochezia

DOI: 10.17235/reed.2020.7358/2020

Review

New non-invasive biomarkers for colorectal cancer screening

DOI: 10.17235/reed.2020.7233/2020

Editorial

Reflex testing. A key tool for the elimination of hepatitis C

DOI: 10.17235/reed.2020.7201/2020

Letter

Lumen-apposing metal stent deployment failure

DOI: 10.17235/reed.2020.7060/2020

Letter

Chilaiditi’s and Ogilvie syndromes

DOI: 10.17235/reed.2020.7036/2020

Letter

Hepatocarcinoma diagnosis. Reflection is required

DOI: 10.17235/reed.2020.6845/2019

Letter

Sometimes things are what they seem

DOI: 10.17235/reed.2019.5911/2018

Letter

A giant abdominal collection: when things are not what they seem

DOI: 10.17235/reed.2018.5642/2018

Letter to the Editor

Late migration of a metal stent after EUS-drainage of a pancreatic pseudocyst abscess

DOI: 10.17235/reed.2018.5411/2017

Letter to the Editor

EUS-guided ethanol ablation therapy for gastric stromal tumors

DOI: 10.17235/reed.2017.5361/2017

Letter to the Editor

Sternal cutaneous metastasis of hilar cholangiocarcinoma

DOI: 10.17235/reed.2017.4979/2017

Letter to the Editor

A rectal neuroendocrine neoplasm

DOI: 10.17235/reed.2017.4836/2017

Letter to the Editor

Genetics in idiopathic pancreatitis and acute recurrent pancreatitis

DOI: 10.17235/reed.2017.4632/2016

Letter to the Editor

About human taeniasis and Taenia saginata diagnosis by endoscopy

DOI: 10.17235/reed.2016.4297/2016

Review

Endoscopic ampullectomy: a technical review

DOI: 10.17235/reed.2016.3867/2015

Case Report

Pseudoaneurysm associated with complicated pancreatic pseudocysts

DOI: 10.17235/reed.2016.3855/2015

Case Report

Pelvic inflammatory myofibroblastic tumor mimicking a rectal cancer

DOI: 10.17235/reed.2015.3777/2015

Citation tools
Domínguez-Novoa Y, Domínguez-Muñoz E, Martínez-Seara X, Lariño-Noia J, Iglesias-García J. Evaluation of pancreatic microvascularization in chronic pancreatitis by endoscopic ultrasound-guided detective flow imaging: a prospective, single-center, observational study. 11054/2025


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 8 visits.
This article has been downloaded 0 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 05/01/2025

Accepted: 18/02/2025

Online First: 11/03/2025

Published: 08/07/2025

Article Online First time: 65 days

Article editing time: 184 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2025 y Creative Commons. The Spanish Journal of Gastroenterology