Pancreas (IMAGES) Flashcards
Transverse image of the pancreas showing the relationship of the pancreatic head (PH), pancreatic body, and pancreatic tail (PI) to the aorta (AO), inferior vena cava (IVG), splenic vein (SV), superior messenteric vein (SMV), uncinate process (U), and right renal artery (RRA).
Focal acute pancreatitis.
A. Transverse image of the pancreas reveals the duodenum (D), liver (1), inferior vena cava (i), aorta (A), superior mesenteric artery (a), superior mesenteric vein (v), and an enlarged pancreatic head (H).
B. Longitudinal image of the pancreatic head (H) between calipers.
Diffuse acute pancreatitis.
This transverse image of a diffusely enlarged and hypochoic pancreas (P) demonstrates diffuse acute pancreatitis.
Also seen in this image are the portal confluence (p), superior mesenteric artery (a), aorta (A), inferior vena cava (i), and liver
Pancreatic pseudocyst.
Longitudinal image showing pancreatic pseudocysts arising from the tail of the pancreas (P) in a patient with acute pancreatitis.
Chronic pancreatitis.
Transverse image of a pancreas demonstrates multiple parenchymal calcifications (arrows), a sonographic sign of chronic pancreatitis.
The superior mesenteric artery (a) and splenic vein (s)
Courvoisier gallbladder.
This gallbladder was enlarged, measuring greater than 5 cm in width, contained sludge, and was associated with a malignant pancreatic head mass.
Dilated common bile duct.
This dilated common bile duct (between calipers) measured more than 2 cm in diameter. It was associated with a malignant pancreatic head mass.
Pancreatic carcinoma.
A solid hypochoic mass (between calipers) representing pancreatic carcinoma is noted in the head of the pancreas.
Insulinoma.
A. A hypochoic mass is noted within the pancreas (between calipers).
B. The mass appears to be highly vascular.
Dilated pancreatic duct
chronic pancreatitis.
A, Calcifications are seen along the body of the pancreas (P). L, Liver; Sv, splenic vein.
B, The pancreas is shrunken in size.
C, The pancreatic duct is enlarged.
typical pancreatic pseudocyst.
acute hemorrhagic pancreatitis.
Hemorrhagic fat necrosis and a pseudocyst filled with blood are seen on cross section.
B, Pancreatitis with hemorrhage.
The gland is enlarged and echogenic secondary to freshly clotted blood.
L, Liver; P, pancreas; SMV, superior mesenteric vein.
Hemorrhagic phlegmon is a complication of pancreatitis.
The phlegmon is ill defined as it lies anterior to the kidney.
A pancreatic abscess
imaged with sonography as a poorly defined hy-poechoic mass with smooth or irregular thick walls, causing few internal echoes; it may be echo-tree to echodense.
A 65-year-old patient with cystadenoma in the head of the pancreas that is not causing obstruction of the pancreatic duct.
A, Transverse image of the pancreas (P), pancreatic duct (arrows), splenic vein (S), superior mesenteric artery (a), left renal vein (LRV), and aorta (A).
B, Large mass (M) in the head of the pancreas seen compressing the inferior vena cava (IVC).
Mucinous cystadenoma.
This lesion presents as well-circumscribed, smooth-surfaced, thin- or thick-walled, unilocular or multilocular cystic lesions of variable sizes comprised of well-defined cysts containing thick mucinous fluid, internal septations, or mural nodules.
The intraductal papillary mucinous tumor branch type shows a single or multicystic mass with a microcystic or mac-rocystic appearance. (Biopsy needle is noted.)
Adenocarcinoma of the pancreas.
A, Transverse images of the pancreas demonstrate a large heterogeneous irregular lesion within the tail of the gland.
B, Moderate heterogeneous lesion (arrows) in the head of the gland, causing obstruction of the common bile duct.
C, Large irregular heterogenous lesion in the head of the pancreas with pancreatic ducal enlargement.
A, An intraab-dominal lymphoma may appear as a hypochoic mass or with necrosis, a cystic mass in the pan-creas. B, Sagittal sonogram of the midabdomen demonstrates multiple enlarged homogeneous lymph nodes (arrows) surrounding the inferior vena cava (IVC).
Annular pancreas occurs when the ventral bud fails to rotate with the duodenum and instead surrounds it.
This may result in duodenal obstruction.
the head of the pancreas surrounds the second portion of the duodenum.
The small gastroduodenal artery (gda) is the an-terolateral border of the head of the pancreas. A, Aorta.
splenic vein is seen as a circle on the sagittal plane as it flows along the posteromedial border of the pancreas (arrow).
A middle-aged male presented with midepigastric pain, elevated amylase and lipase levels, and tenderness. The pancreas is diffusely enlarged representing?
Acute pancreatitis
pancreas is diffusely enlarged
Transverse scans over the upper abdomen show the inflamed pancreatic tissue
acute pancreatitis
the gland is hypochoic to anechoic and is less echogenic than the liver because of the increased prominence of lobulations and congested vessels.
Gross specimen of an inflamed pancreas.
37-year-old male patient with AIDS presented with pancreatitis, hepatosplenomegaly, and peripancreatic adenopathy.
The pancreas is enlarged and slightly hypochoic.
A, Aorta; IC, inferior vena cava; P, pancreas; SV, splenic vein. C, Sagittal scan of the enlarged pancreas (P) with adenopathy (arrows).
Ultrasound patterns in chronic pancreatitis.
A, Calcifications are seen along the body of the pancreas (P). L, Liver; SV, splenic vein.
B. The pancreas is shrunken in size.
C, The pancreatic duct is enlarged.
acute hemorrhagic pancreatitis.
Hemorrhagic fat necrosis and a pseudocyst filled with blood are seen on cross section.
B, Pancreatitis with hemorrhage.
The gland is enlarged and echogenic secondary to freshly clotted blood. L, Liver; P, pancreas; SMV, superior mesenteric vein.
Hemorrhagic phlegmon is a complication of pan-creatitis. The phlegmon is ill defined as it lies anterior to the kidney.
pancreatic abscess is imaged with sonography as a poorly defined hypoechoic mass with smooth or irregular thick walls, causing few internal echoes; it may be echo-free to echodense.
65-year-old patient with cystadenoma in the head of the pancreas that is not causing obstruction of the pancreatic duct.
A, Transverse image of the pancreas (P), pancreatic duct (arrows), splenic vein (SV), superior mesenteric artery (a), left renal vein (LRV), and aorta (A).
B, Large mass (M) in the head of the pancreas seen compressing the inferior vena cava (IC).
Mucinous cystadenoma.
This lesion presents as well-circumscribed, smooth-surfaced, thin- or thick-walled, unilocular or multilocular cystic lesions of variable sizes comprised of well-defined cysts containing thick mucinous fluid, internal septations, or mural nodules.
The intraductal papillary mucinous tumor branch type shows a single or multicystic mass with a microcystic or mac-rocystic appearance. (Biopsy needle is noted.)
Adenocarcinoma of the pancreas.
A, Transverse images of the pancreas demonstrate a large heterogeneous irregular lesion within the tail of the gland.
B, Moderate heterogeneous lesion (arrows) in the head of the gland, causing obstruction of the common bile duct.
C, Large irregular heterogenous lesion in the head of the pancreas with pancreatic ductal enlargement.
A, An intraab-dominal lymphoma may appear as a hypochoic mass or with necrosis, a cystic mass in the pancreas.
B, Sagittal sonogram of the midabdomen demonstrates multiple enlarged homogeneous lymph nodes (arrows) surrounding the inferior vena cava (IVC).
