The value of contrast-enhanced harmonic endoscopic ultrasound in the diagnosis of periampullary mass

Background: Periampullary masses encompass both benign and malignant lesions that are clinically challenging to differentiate. This study aimed to investigate the diagnostic value of contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) for periampullary masses and compare its performance with computed tomography (CT) and magnetic resonance imaging (MRI). Methods: We conducted a retrospective analysis of 54 patients with pathologically confirmed malignant periampullary masses or benign lesions validated by ≥1-year follow-up. Diagnostic efficacy of CH-EUS was evaluated against CT and MRI. Results: All malignant masses exhibited arterial-phase hypo-enhancement, while 78.94% of benign lesions showed iso-enhancement. Venous-phase hypo-enhancement was observed in 94.28% of malignancies and 57.89% of benign cases demonstrated iso-enhancement. CH-EUS demonstrated superior diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) compared to CT (all p<0.05). Its accuracy and sensitivity also exceeded those of MRI (p<0.05). Conclusion: CH-EUS effectively differentiates benign and malignant periampullary masses, demonstrating high clinical utility.