Evaluation of the pancreatic duct: a reappraisal based on a retrospective correlative study by sonography and pancreatography in 117 normal and pathologic subjects.

A retrospective study of 117 normal and pathologic pancreatic ducts by endoscopic retrograde cholangiopancreatography (ERCP), with ultrasonic correlation in 80 cases, confirmed the value of ultrasound in the diagnosis of ductal dilatation. The specificity of ultrasound is good: the ultrasonic discovery of a dilatation constitutes a relevant feature. Sensitivity is however poor, particularly in moderate and localized dilatations: a suggestive clinical picture requires ERCP even if sonography is in favor of a normal pancreatic duct. Correlative measurements show discrepancies, with higher ERCP values in normal subjects. The average ERCP diameter in the corporeal ductal segment is 2.6 mm. Until correlative results arising from a prospective study are available, the ultrasonic diagnosis of ductal dilatation must take into account the high normal values demonstrated by ERCP.