Detection of pancreatic tumors by ultrasound during surgery
B. Sigel, J. C. Coelho, L. M. Nyhus, J. M. Velasco, P. E. Donahue, D. K. Wood and D. G. Spigos
Real-time B-mode ultrasonic scanning was performed during 14 operations for
pancreatic tumors. All operations were for adenocarcinoma, except in one
patient with a Zollinger-Ellison tumor. The ultrasonic tissue appearance of
pancreatic carcinoma was not specific. However, ultrasonic signs of
pancreatic duct dilation, striction or invasion of the superior mesenteric
veins, and common bile duct involvement may help to establish the diagnosis
of malignancy. A triad of ultrasound signs indicative of malignant
obstruction of the common bile duct consisted of (1) dilation, (2) absence
of biliary stones, and (3) a distinctive termination pattern of the duct.
Operative ultrasound was used to guide a biopsy needle to obtain pancreatic
tissue samples. The Zollinger-Ellison tumor of the pancreas produced a
sonolucent appearance that clearly distinguished it from the surrounding
tissue.
