Ultrasonographic diagnosis of pancreatic and peripancreatic cancer

ABSTRACT

Seventeen cases of cancers in and adjacent to the pancreas were studied by high resolution and wide field realtime ultrasonographic scanner with 3.5MHz linear array electronically focusing transducer. The results were asfollows; 1. In a total of 17 cases, 7 cases were pancreatic cancers and the rests were 3 cases of ampulla of Vatercancers, 3 cases of distal CBD cancers, and 4 cases of metastatic cancers, respectively. 2. Pancreatic cancerswere located mainly in head portion, and metastatic cancers were noted in head, tail, and retropancreatic areas.3. The sized of all distal CBD cancer were less than 1.8cm, usually smaller than other tumors, and the size ofmetastatic cancers were variable (1-6cm). 4. The shape, margin, contour and echogenicity of the tumors werevariable. 5. Pancreatic duct showed marked dilatation in one of pancreatic cancer, and mild dilatation in one ofampullar of Vater cancer. 6. The caliber of extrahepatic duct were moderately or markedly dilated in nearly allcases except 2 cases of pancreatic body cancer. 7. The pancreatic margin is partially obliterated in pancreaticand ampulla of Vater cancers but not in distal CBD cancer. 8. Gallbladder enlargement is secondary change due tothe obstruction of extrahepatic bile duct. 9. Effects on the vessles are due to not only direct mass effect butdirect invasion resulting in obliteration. The most commonly involved vessels are spleno-portal junction, splenicvein and portal vein. In case of pancreatic cancer in uncinated process, the superior mesenteric vessels aredisplaced anteriorly. 10. Surrounding metastatic lesions were suspected in pancreatic and ampulla of Vater cancer,but not seen in distal CBD cancer. 11. Ascites were seen in only two cases of metastasis.