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Atlas of Human Body Ultrasound Scanning_ Methods and Diagnostic Applications ( PDFDrive ).pdf
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2.7\ Longitudinal Scanning of the Intrapancreatic Port and the end Part of the Common Bile Duct by the Right Subcostal and Right Upper Abdomen

Fig. 8.38  Longitudinal scanning of the intrapancreatic port of the common biliary duct by the right subcostal and right upper abdomen

RL

PV

IVC

M. Zhang

GB

PH

CBD

Du

8  The Digestive System Organ Scanning

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2.7.1\ Scanning Method

The patient should be on fast for 8–12 hours with a supine position. Subcostal and right upper abdomen longitudinal scanning are performed. After showing the longitudinal plane of the common bile duct, the transducer rotates 10–15° in the same clockwise direction from the parallel to the middle line approximately.

2.7.2\ Section Structure

Major areas: longitudinal scanning of the posterior pancreatic port and end segment of the common bile duct. The middle portion of the common bile duct runs posterior to the duodenum. Inferiorly the distal common bile duct enters the pancreatic head and travels along the posterior-most aspect of it, where it is joined by the main pancreatic duct and common bile duct to form the ampulla of Vater. In this plane, the ampulla of Vater can be shown as a spindle expansion in most of subjects. In part of subjects the common bile duct can open into the duodenum directly and does not form the ampulla. Ancillary areas: oblique section of the pancreatic head, gallbladder, right liver lobe, inferior vena cava, and portal vein.

2.7.3\ Measuring Methods

and Normal

Measuring diameter of the intrapancreatic portion of the common bile duct. Normal: Normal: The normal value of inner diameter should be <0.6 cm, 0.6–0.8 cm inner diameterin as the critical value; be sure to follow up observations or conduct further examination. The inner diameter being larger than 0.8 cm as an upper limit indicates common bile duct dilatation. Bile duct diameter is wider in patients who had accepted cholecystectomies. The CBD inner diameter can increase with age but rarely more than 1.0 cm.

2.7.4\ Clinical Application Value

This section is used to observe the intrapancreatic portion and end segment of the common bile duct. The obstruction; the presence of expanded, narrow, calculus, or space-occupying lesions; as well as lesions around the porta hepatis area can be found in this plane. It can also be used to find the tumor of the ampulla of Vater and duodenal papilla.