Double Contrast‐Enhanced Ultrasonographic Features of Gastric Heterotopic Pancreas

OBJECTIVES: The purpose of this study was to analyze the features of double contrast-enhanced ultrasound (DCEUS) in gastric heterotopic pancreas. METHODS: We retrospectively analyzed the DCEUS images (grayscale, color Doppler, and CEUS) of patients diagnosed with gastric heterotopic pancreas based on B-mode endoscopic ultrasound (EUS) findings in our hospital between January 2017 and December 2025. RESULTS: A total of 30 patients were included during the study period (16 women and 14 men, aged from 7 to 73 years, with a mean age of 51.6 years). The lesions were predominantly located in the gastric antrum (23/30). On grayscale ultrasound, most lesions presented as flattened masses (23/30), showing hypoechoic (11/30), or isoechoic (16/30) echogenicity with clear boundaries (22/30), and most originated from the submucosal layer (22/30). Color Doppler ultrasound showed absent or only minimal intralesional blood flow in the vast majority of cases (28/30). On CEUS, all lesions demonstrated hyperenhancement, with a fast-in and slow-out enhancement pattern observed in most cases (24/30). Internal duct-like structures were seen in 12 patients (12/30), and central umbilication was observed in 6 patients (6/30). CONCLUSION: Gastric heterotopic pancreas demonstrates relatively characteristic DCEUS features, which can provide non-invasive imaging evidence to support EUS-based diagnosis.