Real-time sonography of the pancreatic duct: application to percutaneous pancreatic ductography.

Using a linear-array electronic real-time scanner, ultrasonic pancreatograms were obtained in 21 of 25 normal adults and in 28 of 29 patients with pancreatic disease. The normal pancreatic duct was seen as a thin anechoic tube with echogenic walls and an inner diameter under 0.8 mm. In patients with pancreatic disease, changes in the duct such as dilatation, obstruction, and pancreatic stones could be seen. When ultrasonic pancreatograms were compared with endoscopic pancreatograms in the same patients, there was a good correlation in the patterns of duct dilatation. Using a real-time transducer to guide a thin needle for puncture, both percutaneous pancreatic ductography and percutaneous aspiration biopsy of the pancreas were successfully performed as a single procedure in eight patients with carcinoma of the head of the pancreas. There were no major complications, and the examination provided a definitive diagnosis in all patients.