Online Journal
IF値: 0.677(2017年)→0.966(2018年)


Journal of Medical Ultrasonics

にて英文誌のFull textを閲覧することができます.


2008 - Vol.35

Vol.35 No.02

Review Article(総説)

(0155 - 0162)


Interpreting extratransabdominal ultrasonographic findings in patients with pancreaticobiliary diseases

糸井 隆夫, 祖父尼 淳, 糸川 文英, 栗原 俊夫, 森安 史典

Takao ITOI, Atsushi SOFUNI, Fumihide ITOKAWA, Toshio KURIHARA, Fuminori MORIYASU


Gastroenteology and Hepatology, Tokyo Medical University

キーワード : extratransabdominal ultrasonography, pancreaticobiliary diseases, fundamental imaging, tissue harmonic imaging


We explain basic imaging methods and important points concerning transabdominal ultrasonography in patients with pancreaticobiliary diseases. When imaging the intrahepatic bile duct, it is important to recognize that it is adjacent to the portal vein in Glisson′s capsule. Distinguishing between the portal vein and the bile duct is simplified with the use of Doppler ultrasound. It is essential to note dilatation and mass in the intrahepatic bile duct. To detect the lumen of the extrahepatic bile duct next to the portal vein, we repeatedly moved the probe diagonally toward the midline of the abdomen, descending along the axis from the middle of the right costal arch and moving it toward the pelvis. Doppler mode ultrasound is also useful in this procedure. Once the portal vein is located, the extrahepatic duct along it is traced. An alternative method involves imaging from a left lateral decubitus approach to detect the intrapancreatic bile duct, then fixing on it and rotating the probe about 90° to allow detection and following the image of the duct laterally. Pathologic conditions include bile duct dilatation, intraluminal lesions, and changes in the wall of the bile duct. To visualize the gallbladder, first locate the gallbladder bed as a landmark and then follow it to the hepatoduodenal ligament. Particular care is necessary in imaging the neck and fundal portion of the gallbladder, which are easily overlooked. Note the size of the gallbladder and the condition of the lumen and gallbladder wall. The entire pancreas is observed along its long axis using the splenic vein as a landmark. The bifurcation of the splenic vein is seen near the pancreatic tail, but because imaging is often insufficient using wide scanning, depiction from the left intercostals space may be better. The size of the pancreas, condition of the main pancreatic duct, and presence of any dilatation or mass must be carefully noted.