Pancreas and aging: a study using ultrasonography

The pancreas undergoes a continuous aging process leading to alterations such as atrophy, fatty infiltration and fibrosis.

The aim of this study was to determine the normal ultrasonic aspect of the pancreas and any relationship to age with special regard to pancreatic echogenicity and pancreatic duct diameter.

In the study on pancreatic echogenicity 131 patients (56 male, 75 female), aged 18-92 (median 52) years, with normal weight were examined prospectively. The echogenicity of the pancreas was compared with the normal liver and divided into four different categories. The prospective investigation into any age relationship of pancreatic duct diameter was performed on 101 patients (44 male, 57 female), ages 18-91 (median 53) years, with normal weight. In both studies, the patients were split into seven age groups. For statistical analysis the chi-square test for independence was used.

With advancing age, ultrasonography demonstrated an increasing echogenicity of the pancreas, beginning in the 4th decade of life. Most patients over 50 years, and all patients over 80 had a marked echogenicity, distinctly higher than that found in the liver. The mean pancreatic duct diameter of all patients in the second study was 1.9 mm. Younger subjects had a smaller diameter - average 1.5 mm in the group 18-29 years - but with advancing age a distinct duct enlargement was observed: mean 1. 9 mm in the group 40-49 years, mean 2.3 mm in patients over 80 years, but not exceeding 3 mm.

On ultrasonography, the aging process of the pancreas leads to an increase of echogenicity. In the aged, a very high echogenicity is a normal ultrasonic finding. The pancreatic duct diameter also increases with advancing age. Even in advanced age, a diameter of more than 3 mm, however, should be regarded as a pathological finding.