Добавил:
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз: Предмет: Файл:
Atlas of Human Body Ultrasound Scanning_ Methods and Diagnostic Applications ( PDFDrive ).pdf
Скачиваний:
98
Добавлен:
29.07.2022
Размер:
40.13 Mб
Скачать

282

M. Zhang

 

 

3\ The Pancreas

3.1\ Transverse Scanning

of the Pancreas by Subxiphoid

Fig. 8.41  Transverse view of the pancreas by subxiphoid

St

LL

PH

PB

 

CBD

PT

CA

IVC

 

St

PH

CBD

IVC

Ao

SpV

Ao

LL

PB

PT

SpV SMA

LK

8  The Digestive System Organ Scanning

283

 

 

3.1.1\ Scanning Method

The patient should be on fast for 8–12 h. Subxiphoid transverse scanning should be performed with patient in a supine position. Probe should be put transversely to high right lower left. Patients can be in full inspiration to make left liver lobe go down as an acoustic window and distend the splenic vein as a landmark in visualizing the pancreas. Filling the stomach by drinking water as an acoustic window may be useful for fully visualizing the head or tail of the gland.

3.1.2\ Section Structure

Major areas: the pancreas; the pancreas can take the shape of a tadpole, sausage, or dumbbell.

Ancillary areas: long axial section of the spleen vein and transverse section of the abdominal aorta and superior mesenteric artery, superior mesenteric vein, inferior vena cava, and left kidney. The point of pancreas anterior to the left edge of the abdominal aorta can be a boundary of the pancreatic body and the pancreatic tail generally. The pancreatic parenchyma echogenicity is

isoechoic compared to the liver but can be hyperechoic in old people or obese people.

3.1.3\ Measuring Method and Normal

Measuring transverse and sagittal diameter of the pancreatic head. Two measuring line should be vertical, measuring the anteroposterior diameter of the pancreatic body aorta and the anteroposterior diameter of the pancreatic tail anterior to left kidney. Pancreatic diameter: transverse diameter of pancreatic head is <3.0 cm, anteroposterior diameter 2.7 ± 0.3 cm, anterioposterior diameter of pancreatic body 1.6–2.0 cm, and >2.0 cm abnormal; size of the pancreatic tail is different due to the different shape. The main pancreatic duct diameter should be <0.2 cm.

3.1.4\ Clinical Application Value

It is the standard section and is used to judge and measure the size of the pancreas and to diagnose diffuse diseases and the space-occupying diseases of the pancreas.

284

M. Zhang

 

 

3.2\ Transverse Scanning of the

Upper Portion of the Pancreatic Head by the Right Subcostal

Fig. 8.42  Transverse scanning of the upper portion of the pancreatic head by the right subcostal. Notes: 1 SMV, 2 Gastroduodenal artery, 3 CBD

Au

 

PH

SpA

 

 

2

 

1

3

 

 

Ao

 

 

 

IVC

 

Au

2

3

LL

PH

SpA

1

Ao

IVC

8  The Digestive System Organ Scanning

285

 

 

3.2.1\ Scanning Method

The patient should be on fast for 8–12 hours. Transverse scanning should be performed with patient in a supine position. Probe should be put transversely on subxiphoid. The patient can be in full inspiration to make the left liver lobe go down as an acoustic window may be useful to show the pancreatic head clearly.

3.2.2\ Section Structure

Major areas: the transverse section of the middle and upper portion of the pancreatic head and middle segment of the common bile duct. Ancillary areas: transverse sections of the abdominal aorta, superior mesenteric artery, superior mesenteric vein, inferior vena cava, and gastric antrum are shown.

3.2.3\ Measuring Method and Normal

The inner diameter of the common bile duct posterior to the pancreatic head can be measured.

3.2.4\ Clinical Application Value

(1) The shape, size, and parenchymal echoes of the pancreatic head are observed. (2) Showing the lumen of the common bile duct can determine where the lesion is located at. It can be used to understand the relationship between the common bile duct and the pancreatic head as well as the relationship between the lesion in the pancreatic head and the common bile duct.