Intraduktale Sonographie (IDUS) des Pankreas - Ein Verfahren mit diagnostischer Perspektive?

Abstract

For the first time, human pancreas specimens (18 autopsy specimens, three resection specimens) were examined with high-resolution, flexible ultrasound catheters (20 MHz; 3.5 F, 4.8 F, 5.0 F and 6.0 F external diameters; mechanical and electronic systems). The ultrasound catheter was easily inserted into the pancreatic duct in all specimens. The sonographic tissue texture was correlated with its histological picture at defined positions. A high resolution was thus achieved in the sonomorphological differentiation of blood vessels, duct system elements, fibrotic tissue, fatty tissue and pancreas tissue with varying lipomatous composition. In a radius of an average of 5.5 mm, structures 0.1 mm large were recognised. Contrast media studies of the ductal system were carried out before and after ultrasound examination. No evidence of trauma due to catheterisation was found either with these studies or by histology. In one case, a 15 mm serous microcystic adenoma of the pancreatic head was found at intraductal examination of the resection specimen. Clinical examinations within the framework of endoscopic retrograde pancreaticography must clarify if the intraductal ultrasonography technique presented here can truly enlarge the diagnostic, repertoire used in the search of tiny focal pancreatic lesions.