Sirli Roxana, Sporea Ioan
Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timişoara, Romania.
Med Ultrason. 2010 Mar;12(1):62-5.
The pancreas is a challenge for the beginner in ultrasonography, but patience, perseverance and experience will lead to a complete and correct evaluation of the organ in almost all cases. A correct examination of the pancreas requires the patient's fasting 7 to 8 hours before the examination. Transverse and longitudinal upper epigastric sections are used to visualize the pancreas, as well as oblique intercostal and subcostal sections (especially for the head and tail). The best ultrasound windows are obtained by using high epigastric sections (that avoid the colon), also by using transgastric sections and sections that use the left liver lobe as an acoustic window. In order to better visualize the pancreas, it is useful to invite the patient to drink 500-700 ml of still water 10-15 minutes before the examination. To highlight the pancreas, we will start by viewing the landmarks: posterior--the porto-splenic axis and anterior--the gastric antrum and/or the left liver lobe. The echogeneity of the normal pancreas can vary, from hypoechoic to hyperechoic, all normal, provided that the pancreatic parenchyma structure is fine and homogeneous. The Wirsung duct can be visualized in some of the cases, especially in thin patients, its normal maximum diameter should be < 2 mm. For a correct evaluation of the pancreas all its segments must be visualized: head, uncinate process, body, and tail - the latter being the most difficult to visualize.
胰腺对于超声检查初学者来说是个挑战，但耐心、毅力和经验几乎能在所有情况下对该器官进行完整且正确的评估。对胰腺进行正确检查需要患者在检查前禁食7至8小时。使用上腹部横切和纵切来观察胰腺，以及斜位肋间和肋下切面（特别是针对头部和尾部）。通过使用上腹部高位切面（避开结肠）、经胃切面以及以左肝叶作为声窗的切面可获得最佳超声检查窗口。为了更好地观察胰腺，在检查前10至15分钟让患者饮用500 - 700毫升静水是有用的。为突出胰腺，我们将先观察标志：后方——脾门静脉轴，前方——胃窦和/或左肝叶。正常胰腺的回声可有所不同，从低回声到高回声，只要胰腺实质结构精细且均匀，均属正常。在某些情况下，尤其是瘦患者中，可观察到主胰管，其正常最大直径应<2毫米。为了对胰腺进行正确评估，必须观察其所有节段：头部、钩突、体部和尾部——后者最难观察到。
