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Atlas of Human Body Ultrasound Scanning_ Methods and Diagnostic Applications ( PDFDrive ).pdf
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M. Zhang

 

 

3.3\ Transverse Scanning of the Lower Port of the Pancreatic Head by Subxiphoid

Fig. 8.43  Transverse scanning of the lower portion of the pancreatic head by subxiphoid

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3.3.1\ Scanning Method

The patient should be on fast for 8–12 h. Transverse scanning by subxiphoid should be performed with patient supine position. After showing the standard transverse plane of the pancreas, the transducer moves down toward the right interior. That patients can be in full inspiration to make the liver move down as an acoustic window may be useful to show the pancreatic head clearly.

3.3.2\ Section Structure

Major areas: the pancreatic head and distal segment of the common bile duct are shown. The common bile duct runs to the right portion of the

pancreatic head and is joined by the main pancreatic duct to form together a small ampulla of Vater. Joined port or double tube sign can be shown when the main pancreatic duct is dilated. Ancillary areas: transverse section of abdominal aorta and superior mesenteric artery, superior mesenteric vein, and inferior vena cava.

3.3.3\ Clinical Application Value

To observe the shape, size, and parenchymal echoes of the lower portion of the pancreatic head, end segment of the common bile duct, and the ampulla of Vater. It is very important plane for us to diagnose the carcinoma and stone of the pancreatic head and ampulla of Vater.

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3.4\ Sagittal Scanning of the

Pancreatic Head by the Right

Upper Abdomen

Fig. 8.44  Sagittal scan of the pancreatic head by the right upper abdomen

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3.4.1\ Scanning Method

The patient should be on fast for 8–12 h with a supine position. Sagittal scanning by putting the probe on the right upper abdomen should be performed. The patient will be in full inspiration if necessary.

3.4.2\ Section Structure

Major area: sagittal section of the pancreatic head.

Ancillary areas: long axial view of the inferior vena cava, the right lobe of the liver, and the gallbladder.

3.4.3\ Measuring Method and Normal

The superoinferior diameter and anteroposterior diameter of the pancreatic head are measured. Normal value of the superoinferior diameter is

3.6 ± 1.2 cm (Haber) and anteroposterior diameter 2.7 ± 0.7 cm (Haber) and 2.2 ± 0.3 cm (Niederau). The normal value in Chinese adult: anteroposterior diameter should be lesser than 2.0 cm, and 2.1–2.5 cm is thought to be suspicious of being abnormal. When it is larger than 2.6 cm, it is abnormal. There may be obvious individual differences in the superoinferior diameter of the pancreatic head.

3.4.4\ Clinical Application Value

We can judge whether the size of the pancreatic head is normal, especially whether there are increases in the superoinferior diameter and the anteroposterior of the pancreatic head. To determine whether there is a clear and neat capsule and whether there is a clear boundary between the pancreas and the surrounding organs.