Fig. 8.45  Sagittal scanning of the pancreatic body by the subxiphoid

3.5.1\ Scanning Method

The patient should be on fast for 8–12 h. Scanning should be performed with patient in a supine position and will be in full inspiration if necessary. Probe should be put vertically on the subxiphoid, slightly oblique to the left.

3.5.2\ Section Structure

Major area: sagittal section of the pancreatic body.

Ancillary areas: longitudinal section of the superior mesenteric vein, oblique section of the inferior vena cava, and sagittal section of the left hepatic lobe and stomach are shown.

3.5.3\ Measuring Method and Normal

The superoinferior diameter and anteroposterior diameter of the pancreatic body are measured. It should be less than 2 cm in normal.

3.5.4\ Clinical Application Value

This section is usually used to show whether there is an enlargement of the pancreatic body, especially whether the superoinferior diameter increases and the edge of the pancreas is clear and neat, and whether there is a clear boundary between the pancreas and the organs surrounding it.

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3.6\ Oblique Scanning

of the Pancreatic Tail by

the Left Upper Abdomen

Fig. 8.46  Long axial section of the pancreatic tail by left upper the abdomen

SMV

IVC

Ao

M. Zhang

PB

SpV

PT

3.6.1\ Scanning Method

The patient should be on fast for 8–12 hour. The transducer is oblique put on the subxiphoid a little left to the middle line or on the left subcostal and parallel to the long axis of the pancreatic tail. Oblique scanning of the pancreatic tail should be performed with a supine position of the patient. The splenic vein can act as a landmark in visualizing the pancreatic tail. The pancreatic tail cannot be revealed in a few portions of the patients.

Filling the stomach by drinking water as an acoustic window, giving a press to the left upper abdomen by probe, taking a deep breath to make the left liver move down as an acoustic window, changing the patient’s position to take the spleen or left kidney as an acoustic window may be useful for full visualization.

3.6.2\ Section Structure

Major area: long axial section of the pancreatic tail is shown.

Ancillary areas: long axial section of the spleen vein and transverse section of the abdominal aorta and superior mesenteric artery, superior

mesenteric vein, inferior vena cava, and left kidney are seen. The point of the pancreas anterior to left edge of the abdominal aorta can be a boundary of the pancreatic body and the pancreatic tail. Generally, the pancreatic parenchymal echogenicity is isoechoic but can be hyperechoic compared to the liver in old people or obese people.

3.6.3\ Measuring Method and Normal

The anteroposterior diameter of the pancreatic tail is measured at the point anterior to the left lateral wall of the abdominal aorta. The size of the pancreatic tail is different due to different shapes and different subjects.

3.6.4\ Clinical Application Value

The standard section of the pancreas cannot show the pancreatic tail completely. This section is specifically for the scanned pancreatic tail. It is used to diagnose diffused diseases and the spaceoccupying diseases of the pancreatic tail. Islet cell tumors or a small part of other benign tumors are often found in the tail of the gland.