[Sonography of pancreatic carcinoma. Sonomorphology, diagnostic accuracy and tumor staging]

Ultrasonography was performed in 125 consecutive patients with clinically suspected carcinoma of the pancreas. The most important diagnostic criteria were reflectivity and echo amplitude, which were locally decreased in 71% (50/70) and increased in 27% (19/70) of the cancers. The echogenicity and reflectivity did not differ in four endocrine active tumors and adenocarcinomas. The diagnostic accuracy was 83% (101/122); in 3 patients ultrasonography failed to provide adequate information. Dilation of the biliary tree was found in 68% (43/50) of the carcinomas and dilation of the Wirsungian duct in 52% (32/58). There was some difficulty in differentiating between pancreatic carcinoma and chronic pancreatitis because the echogenicity is similar for both and inflammatory and neoplastic pancreatic processes are also present in both diseases. Although only 2-3 cm in diameter, 87% (7/8) of the carcinomas were already in the T3 stage. Angiography to evaluate resectability is unnecessary only when vascular encasement, extensive infiltration of peripancreatic fat, or tumor thrombus has been demonstrated sonographically.