Results of ultrasound examination of pancreatic cancer

Ultrasound examination of pancreatic cancer is a common examination in clinical practice. What are the manifestations of its examination results?

Pancreatic morphology abnormalities The pancreas is often localized and bulging, and is nodular. Tumors larger than 1 cm or protruding outside the pancreas are easily detected by ultrasound.

2. The boundaries and contours of the pancreatic tumor are irregular or unclear, and the cancer infiltrates the surrounding tissues in a crab-like manner.

3. Abnormal echoes in the pancreas. Pancreatic cancer has low echoes inside, with scattered inhomogeneous light spots in the middle. The back of the tumor is solid attenuation, and occasionally there are strong echo groups. When pancreatic cancer is large, liquefaction and necrosis occur in the center of the tumor, and ultrasound can show irregular echo-free areas.

4. Pancreatic cancer blood flow display. The clinical application of color Doppler ultrasound (CDI) can show the richness of blood flow in tumor tissue to understand whether it is a tumor with many or few blood vessels, and thus understand the type of tumor.

5. When pancreatic cancer compresses surrounding organs, squeezing may occur.

(1) Cancer of the head of the pancreas can cause the duodenal flexure to expand and the liver to be squeezed and displaced. Cancer of the body of the pancreas can easily be felt as a mass in the upper abdomen and can be easily detected by ultrasound. Cancer of the tail of the pancreas can cause the stomach, left kidney, and spleen to be squeezed and displaced.

(2) Pancreatic duct dilatation: When a mass in the pancreatic head blocks the pancreatic duct, the entire duct may be dilated. When a mass in the body and tail of the pancreas blocks the pancreatic duct, the duct may be suddenly cut off or dilated segmentally.

(3) Biliary system dilatation: Pancreatic head mass compresses or infiltrates the common bile duct, causing dilatation of the intrahepatic and extrahepatic bile ducts and enlargement of the gallbladder

(4) The pancreas is rich in blood vessels, such as the abdominal aorta, which branches into the celiac artery and the superior mesenteric artery; the former branches into the common hepatic artery and the splenic artery. The venous system includes the inferior vena cava and the portal vein. If a tumor or disease occurs in the pancreas, it will cause changes such as deformation, bending, and stenosis of the above-mentioned blood vessels. For example, cancer in the head of the pancreas squeezes the inferior vena cava backwards, causing it to narrow and expand at the distal end; cancer in the pancreatic neck can cause compression and displacement of the portal vein and the superior mesenteric vein; cancer in the body and tail of the pancreas can cause displacement of the splenic vein and the superior mesenteric artery. Color Doppler ultrasound can be used to measure the diameter, course, blood flow velocity, and direction of blood vessels, which is helpful for the diagnosis of pancreatic diseases. Secondly, for dilated bile ducts or pancreatic ducts, color Doppler ultrasound can also be used to distinguish between blood vessels or bile ducts and pancreatic ducts, because the latter has no color display.