Irisawa et al correlated changes seen on endoscopic ultrasonography (EUS) of the pancreas and the severity of chronic pancratitis (CP). This can be helpful in establishing the diagnosis early in its course. The authors are from Fukushima Medical University, University of Texas Medical Branch Galveston, All Saints Hospital (Racine, Wisconsin), and Kurihara Central Hospital (Kurihara, Japan).
Patient selection: possible chronic pancreatitis (CP)
Parameters:
(1) area of hyperechoic foci
(2) visible side branch
(3) dilated main branch
(4) duct irregularity
(5) calcification and/or stone
Parameter
Mild CP
Moderate CP
Severe CP
area of hyperechoic foci
5-12 square mm
>= 14 sq mm
>= 14 sq mm, may be > 25 sq mm
visible side branches
no
yes
yes
dilated main branch
no
yes
yes
duct irregularity
no
no
yes
calcification and/or stone
no
no
yes
The normal pancreas has a homogeneous and finely reticular pattern. A normal pancreas may have tiny hyperechoic areas with areas less than 2 square mm.
A circular hyperechoic focus 4 mm in diameter would have an area of 12.6 square mm.
A circular hyperechoic focus 6 mm in diameter has an area of 28.3 square mm.
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