In the process of ultrasound pancreas, it is mandatory to compare its echogenicity with the liver and gall bladder. Separately from other digestive organs, the sonography of the gland is not carried out, because it is absolutely uninformative. If during the ultrasound of the pancreas and comparing it with the liver it was found that the gland has a hypoechoic structure, this may indicate acute pancreatitis. Also acute pancreatitis is characterized by a loss of sharpness of the contour of the gland, which does not prevent the pancreas from being well visualized. Gradually, with the progression of the disease, the contour line continues to disappear.
Hypoehogenicity of the gland can be focal or diffuse. With diffuse changes, it is expressed almost uniformly throughout the pancreas, with insignificant heterogeneous areas of the organ or its contour. But with focal changes you can observe areas of irregular shape, which may not have clear contours, but can, on the contrary, be clearly detailed.
Sometimes there can be a picture in which during the examination of the body hypoechoic zones are visible among the set of hyperechoic fields. This condition of the pancreas occurs if the expressed fibrillopomatous changes occur in the gland, against which the inflammatory and destructive process later developed.
With the progression of acute pancreatitis, the size of the organ also increases, its heterogeneity and hypoechoence become more noticeable. And in many cases this property decreases so much that it becomes almost impossible to distinguish the pancreas from the adjacent portal and splenic vein.
Also areas of reduced echogenicity will be detected and with hemorrhagic pancreatitis, when the echostructure of the gland becomes heterogeneous due to its increase in size and the formation of flow in adjacent soft tissues.
If studies are conducted on a highly sensitive scanner, then in almost 90% of patients with pancreatic sonography it is possible to consider a site of decreased echogenicity, not associated with diseases of the gland. This site is the main pancreatic duct, which is visualized as a hypoechogenic tube with a diameter of 1.3 mm. With age, the duct expands, but normally should not be wider than 2 mm. Sometimes the pancreatic duct is visualized as a thin line.