[Ultrasonic diagnosis of pancreatic conditions: a new tentative at a rational approach based on the analysis of 300 cases which were checked (with real time and degraded intensity scale). (author's transl)].

For a long time, echotomography of the pancreas was limited to the identification of pseudocysts. Little by little, those using ultrasound learnt how to construct images of the pancreatic gland itself, and faced with the changes in size and shape of the latter to recognize lesional processes. Analysis of the pancreatic echostructure represents an important step in the progress of the diagnosis of lesions. Echotomography, the results of which must be compared with those of roentgenological methods of exploration, as well as the clinical and laboratory data, enables the attainment of very fiable diagnoses of chronic pancreatitis with or without pseudo-cysts, of acute pancreatitis or of rare cystic tumors. The precision of the results however depends fundamentally on technical data: it is necessary to combine with the classical apparatus, with manual displacement of the wave, a tomo-echoscopic apparatus, with real time; above all, it is necessary to use the degraded intensity scale. This scale is innate in real time apparatuses. At present it takes the form of a complementary module, on the classical apparatuses. Without these technical conditions, real time and degraded intensity scale, it seems impossible to attack the problem of ultrasonic diagnosis of pancreatic conditions, except by exposing oneself to disappointments which would unmeritedly cast discredit on the method. Six years of experience, several thousands of pancreatic examinations, three hundred pancreatic lesions which were anatomically checked has however convinced us of the importance of echotomography in this field.