Online Journal
IF値: 1.878(2021年)→1.8(2022年)


Journal of Medical Ultrasonics

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2018 - Vol.45

Vol.45 No.05

Review Article(総説)

(0471 - 0480)


How should we evaluate the pancreatobiliary system?-pitfalls and practical solutions-

岡庭 信司1, 岩下 和広2

Shinji OKANIWA1, Kazuhiro IWASHITA2

1飯田市立病院消化器内科, 2飯田市立病院超音波室

1Department of Gastroenterology, Iida Municipal Hospital, 2Division of Ultrasound, Iida Municipal Hospital

キーワード : ultrasound, pancreatobiliary tract, pitfall, cancer screening


As ultrasound (US) is simple and less invasive, it is widely used for mass screening. However, it can be difficult to visualize the entire pancreatobiliary system due to complicated anatomy, obesity, and overlying gas. The left lateral decubitus position is suitable for visualizing the biliary tract system. Both high-resolution US and magnified images are essential. As for the gallbladder, management of artifacts including reverberation and side lobes is a key issue. To trace the total course of the extrahepatic bile duct (EHBD), the probe should be moved as if we are writing an inverse letter C. As the position of the pancreas changes inside the body depending on the posture, we should employ both lateral decubitus positions to delineate the pancreatic head and tail without compressing strongly with the probe. As lesions in the groove area and the ventral pancreas tend to affect neither the EHBD nor the main pancreatic duct (MPD), we should pay attention to those areas. We should also highlight the dilated MPD and pancreatic cysts as important US findings for individuals at high risk for pancreatic carcinoma, and adopt several postural changes and the liquid-filled stomach method to visualize the pancreas with as wide a range as possible.