Ultrasonography in diagnosing chronic pancreatitis: New aspects

Abstract

The course and outcome is poor for most patients with pancreatic diseases. Advances in pancreatic imaging are important in the detection of pancreatic diseases at early stages. Ultrasonography as a diagnostic tool has made, virtually speaking a technical revolution in medical imaging in the new millennium. It has not only become the preferred method for first line imaging, but also, increasingly to clarify the interpretation of other imaging modalities to obtain efficient clinical decision. We review ultrasonography modalities, focusing on advanced pancreatic imaging and its potential to substantially improve diagnosis of pancreatic diseases at earlier stages. In the first section, we describe scanning techniques and examination protocols. Their consequences for image quality and the ability to obtain complete and detailed visualization of the pancreas are discussed. In the second section we outline ultrasonographic characteristics of pancreatic diseases with emphasis on chronic pancreatitis. Finally, new developments in ultrasonography of the pancreas such as contrast enhanced ultrasound and elastography are enlightened.

Keywords: Ultrasonography; Pancreas; Chronic pancreatitis; Transabdominal ultrasound; Medical imaging technique; Contrast enhanced ultrasonography; Elastography; Strain imaging

Core tip: Pancreatic diseases include acute and chronic inflammatory diseases and neoplastic tumors. It is a clinical challenge to diagnose these patients at an early stage because biochemical and imaging signs may be unspecific and are only evident at an advanced stage of the disease. Advances in pancreatic imaging are important for early detection of pancreatic diseases. Ultrasonography, as a diagnostic tool, has undergone major technical improvements over the last decade. It still is the preferred method for first line imaging, as well as it is increasingly used to clarify findings by others imaging modalities to support decision making.