An evaluation of echography in the diagnosis of pancreatic disease.

Abstract

Echography is a fairly recent addition to the methods available for the diagnosis of pancreatic disease and as little work has been reported in this field its diagnostic value has yet to be fully evaluated.The normal pancreas is not always well visualized by echography and it is often difficult to distinguish from the surrounding structure; on the other hand, the diseased pancreas, which is usually enlarged and structurally altered, gives a well-defined picture which may be of great assistance in diagnosis (Engelhardt and Blauenstein, 1970;Filly and Freimanis, 1970;Templeton and Stuber, 1971;Weill et al., 1971;Stuber et al., 1972). In chronic pancreatitis, the characteristic feature of the echogram is total or partial enlargement of the gland and areas of non-homogeneous structure consisting of low echo zones alternating irregularly with high echo zones which may involve the entire pancreas or be confined to certain sections (Filly and Freimanis, 1970). In carcinoma of the pancreas echography reveals enlargement generally confined to one section of the gland, fairly uniform structure, and irregular outlines (Rettenmaier, 1975;Weill et al., 1975). However, it is in the diagnosis of pancreatic cysts that echography gives the clearest picture Received for publication 9 January 1976 showing up transonic areas (typical of fluid collection) which appear as zones completely devoid of echos (Leopold, 1972).In the present study, we describe our experience with this technique in disorders of the pancreas, attempting to assess its value as a diagnostic tool and comparing the results with those obtained from other diagnostic techniques. Method

Endoscopic ultrasonography in the diagnosis of pancreatic islet cell tumors.

“…The popularity of ultrasonography (US) has meant that it has played a primary role in detecting such tumors. 1 However, US is still limited in its ability to detect such small-sized tumors located in the tail of the pancreas. In nonfunctioning tumors, diagnosis is usually not made until the tumor has become enlarged, since symptoms are not evident.…”

Good Agreement Between Transabdominal and Endoscopic Ultrasound of the Pancreas in Chronic Pancreatitis

“…To our knowledge, this is the only report evaluating the performance of US compared to EUS. With the exception of one study by Lutz & Al which was never reproduced [8], our present and recent [11] evaluations represent improvements of the diagnostic performance of US compared to older studies [3][4][5][6][7].…”

“…Transabdominal ultrasonography (US) is the first-line imaging method in the workup of chronic pancreatitis (CP) [1,2]. Previous studies demonstrated varying degrees of diagnostic accuracy of the modality with sensitivities of 40-95 % and specificities of 66-98 % [3][4][5][6][7][8]. Advances in ultrasound technology may have improved diagnostic performance [9,10].…”

EUS liver assessment using contrast agents and elastography

“…The first attention for research and technique development was focused on the evaluation of pancreatic disorders. [ 1 ] In the subsequent decades, the main areas of interest were represented by pancreatic neoplastic and inflammatory diseases, mucosal and subepithelial tumors of the gastrointestinal (GI) wall, and extrahepatic biliary tree disorders ( i.e ., obstruction, jaundice, biliary tree stones, and tumors). [ 2 ] Since the introduction of curvilinear array echoendoscopes in 90's, EUS was not only considered a diagnostic technique for identification and staging but also for interventional approaches, such as tissue acquisition and therapeutic maneuvers.…”