Pancreatic cysts are diagnosed with increasing frequency because of the widespread use of cross-sectional imaging. Pancreatic cysts can either be neoplastic or non-neoplastic, therefore accurate cyst categorization is important. After performing MRI or CT scan as the first methods of examining pancreatic cysts, performing endosonography with FNA helps more in diagnosis. The present study was conducted with the aim of investigating the diagnostic value and role of endosonography in evaluating the characteristics of pancreatic cystic lesions and comparing it with other imaging methods.

In this cross-sectional study, endosonography was performed for patients who were diagnosed with pancreatic cysts,including pure cyst or cyst with solid component based on ultrasound or CT scan. All patients' CT scans were re-evaluated by an experienced radiologist.FNA of cysts were performed and amylase & CEA of cyst fluid and cytology of solid component /mural nodule were performed in all patients.

50 patients with newly diagnosed pancreatic cysts were included. The average age was 56 ± 15 yrs and 34 patients 68%)were female.The results of cysts characteristics in EUS and CT scan was shown in table 1. EUS N (%) CT scan N (%) Size of cyst <10 mm 5(10%) 0(0%) 10-30 mm 20(40%) 12(24%) >30 mm 25(50%) 25(50%) Mural nodule in cyst wall 13(26%) 2(4%) Location of cyst Head 30(60%) 18(36%) Body 16(32%) 15(30%) Tail 4(8%) 4(8%) Irregularity in cyst wall 21(42%) 5(10%) In 13 patients, pancreas cyst was seen in US and EUS,but it was not detected in CT scan. Compared to CT scanner, EUS is significantly more accurate in diagnosing cystic lesions smaller than 10 mm, in detecting mural nodules and determining the characteristics of the cyst wall from CT scan. Based on the characteristics of the cystic lesion in endosonography and the results of the lab tests, the final diagnosis of the patients was as follows: Serous cyst neoplasm 20 patients(40%),Mucinous cyst neoplasm 10 patients(20%),Adenocarcinoma 8 patients(16%) and Intraductal papillary mucinous neoplasms 12 patients(24%)

EUS is an accurate and reliable method in diagnosing pancreatic cystic lesions